Effect of ligation of descending branch of uterine artery combined with oxytocin on postpartum hemorrhage caused by uterine inertia

ZENG Jiang-wei; PAN Chang-qing

doi:10.11659/jjssx.07E022060

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Effect of ligation of descending branch of uterine artery combined with oxytocin on postpartum hemorrhage caused by uterine inertia

Clinical Research | 更新时间：2023-04-24

- Effect of ligation of descending branch of uterine artery combined with oxytocin on postpartum hemorrhage caused by uterine inertia
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 32, Issue 4, Pages: 335-339(2023)
- 作者机构：
  
  电子科技大学医学院附属绵阳医院·绵阳市中心医院妇产科，四川绵阳 621000
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.07E022060
  CLC： R719.6
- Published：25 April 2023，
  
  Received：15 July 2022，
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曾江伟,潘长清.子宫动脉下行支结扎术结合缩宫素治疗宫缩乏力性产后出血的效果[J].局解手术学杂志,2023,32(04):335-339.

ZENG Jiang-wei,PAN Chang-qing.Effect of ligation of descending branch of uterine artery combined with oxytocin on postpartum hemorrhage caused by uterine inertia[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(04):335-339.
曾江伟,潘长清.子宫动脉下行支结扎术结合缩宫素治疗宫缩乏力性产后出血的效果[J].局解手术学杂志,2023,32(04):335-339. DOI： 10.11659/jjssx.07E022060.

ZENG Jiang-wei,PAN Chang-qing.Effect of ligation of descending branch of uterine artery combined with oxytocin on postpartum hemorrhage caused by uterine inertia[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(04):335-339. DOI： 10.11659/jjssx.07E022060.

摘要

目的

探讨子宫动脉下行支结扎术结合缩宫素治疗宫缩乏力性产后出血的临床效果。

方法

选取我院收治的106例宫缩乏力性产后出血患者为研究对象，根据治疗方式将患者分为观察组和对照组。对照组50例患者单纯应用缩宫素治疗，观察组56例患者应用缩宫素结合子宫动脉下行支结扎及宫旁血管钳夹术治疗。比较2组患者的围术期情况、出血情况、术后月经情况、血清性激素水平及并发症情况；评估2组患者产前、产后24 h凝血功能指标变化情况；评价并比较2组患者生产前后的性生活质量。

结果

与对照组比较，观察组手术时间更长，且术中及产后12 h、24 h的出血量更少，止血时间、下床活动时间及住院时间均更短，子宫切除率更低（

0.05）。2组患者术后月经情况及术后6个月的雌二醇（E

）、促卵泡素（LH）和促黄体素（FSH）水平比较差异均无统计学意义(

0.05)。观察组并发症总发生率低于对照组（

0.05）。对照组产后24 h的凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（FIB）水平长/低于观察组（

0.05）。观察组患者产后6个月性功能指标均优于对照组(

0.05)。

结论

缩宫素结合子宫动脉下行支结扎术治疗宫缩乏力性产后出血的止血效果好，且能保留子宫，不影响产后激素分泌，减小凝血功能指标波动，有效提高患者的性生活质量。

Abstract

Objective

To investigate the effect of ligation of descending branch of uterine artery combined with oxytocin in the treatment of postpartum hemorrhage caused by uterine inertia.

Methods

A total of 106 patients with postpartum hemorrhage caused by uterine inertia in our hospital were selected as the research objects，and they were divided into the observation group and the control group according to the treatment methods.Fifty patients in the control group were treated with oxytocin alone，and 56 patients in the observation group were treated with parauterine vascular clipping and ligation of descending branch of uterine artery combined with oxytocin.The perioperative conditions， bleeding conditions，postoperative menstruation，serum sex hormone levels and complications of the two groups were compared.The changes of coagulation function indexes before delivery and 24 hours after delivery of the two groups were evaluated，and the quality of sexual life before and after delivery of the two groups were evaluated and compared.

Results

Compared with the control group，the operation time in the observation group was longer，and the amount of bleeding during operation，12 hours and 24 hours after delivery were less，the time of getting out of bed，hemostasis and hospitalization were shorter，and the hysterectomy rate was lower（

0.05）.There was no significant difference in the postoperative menstruation or the levels of estradiol（E

），luteinizing hormone（LH） and follicle stimulating hormone（FSH） 6 months after surgery between the two groups（

0.05）.The total incidence of complications in the observation group was lower than that in the control group（

0.05）.The prothrombin time（PT），activated partial thromboplastin time（APTT）， thrombin time（TT） and fibrinogen（FIB） 24 hours after delivery in the control group were longer/lower than those in the observation group（

0.05）.The indexes of sexual function 6 months after delivery in the observation group were significantly better than those in the control group（

0.05）.

Conclusion

Oxytocin combined with ligation of descending branch of uterine artery has a good hemostatic effect in the treatment of postpartum hemorrhage caused by uterine inertia， and can preserve the uterus without affecting postpartum hormone secretion， reduce the fluctuation of coagulation function index and effectively improve the quality of sexual life of patients.

关键词

剖宫产产后出血子宫动脉下行支结扎缩宫素

Keywords

cesarean sectionpostpartum hemorrhageligation of descending branch of uterine arteryoxytocin

references

黄闻滢，吴欣瑜.卡贝缩宫素预防剖宫产高危产妇产后出血及凝血功能的疗效［J］.中国医刊，2019，54（9）：986-989.doi：10.3969/j.issn.1008-1070.2019.09.019http://dx.doi.org/10.3969/j.issn.1008-1070.2019.09.019.

汪芬，蒋晖，方莉莉，等.安列克联合葡萄糖酸钙防治宫缩乏力性产后出血的效果观察［J］.中南医学科学杂志，2020，48（4）：406-408.doi：10.15972/j.cnki.43-1509/r.2020.04.017http://dx.doi.org/10.15972/j.cnki.43-1509/r.2020.04.017.

高丽娜，赵会菊.低分子肝素和贝米肝素治疗产后出血所致弥漫性血管内凝血的比较研究［J］.现代药物与临床，2020，35（9）：1882-1885.doi： 10.7501/j.issn.1674-5515.2020.09.033http://dx.doi.org/10.7501/j.issn.1674-5515.2020.09.033.

梁婉琪，张美，李芬霞.B-Lynch缝合术治疗剖宫产产后出血的效果评估及病人术后性生活质量评价［J］.中国性科学，2019，28（3）：86-89.doi：10.3969/j.issn.1672-1993.2019.03.024http://dx.doi.org/10.3969/j.issn.1672-1993.2019.03.024.

何顺华，叶为群.改良B-Lynch缝合联合缩宫素在治疗产后出血效果及对血清性激素水平的影响［J］.中国计划生育学杂志，2018，26（10）：980-983.doi：10.3969/j.issn.1004-8189.2018.10.023http://dx.doi.org/10.3969/j.issn.1004-8189.2018.10.023.

王蕊.子宫动脉下行支结扎术治疗产后出血的临床价值分析［J］.数理医药学杂志，2019，32（8）：1150-1151.doi：10.3969/j.issn.1004-4337.2019.08.021http://dx.doi.org/10.3969/j.issn.1004-4337.2019.08.021.

楼青青，张琴薇，姚慧岚，等.女性性功能量表的汉化及其信效度评价［J］.中国实用护理杂志，2013，29（10）：23-26.doi：10.3760/cma.j.issn.1672-7088.2013.10.007http://dx.doi.org/10.3760/cma.j.issn.1672-7088.2013.10.007.

刘彬彬.卡前列素氨丁三醇联合缩宫素对剖宫产产妇产后出血的疗效及对凝血功能、氧化应激指标的影响［J］.中国妇幼保健，2020，35（7）：1228-1231.doi：10.19829/j.zgfybj.issn.1001-4411. 2020.07.018http://dx.doi.org/10.19829/j.zgfybj.issn.1001-4411.2020.07.018.

Bienstock JL，Eke AC，HueppchenNA.Postpartum hemorrhage［J］.N Engl J Med，2021，384（17）：1635-1645.doi：10.1056/NEJMra 1513247http://dx.doi.org/10.1056/NEJMra1513247.

Higgins N，Patel SK，Toledo P.Postpartum hemorrhage revisited：new challenges and solutions［J］.CurrOpin Anaesthesiol，2019，32（3）：278-284.doi：10.1097/ACO.0000000000000717http://dx.doi.org/10.1097/ACO.0000000000000717.

Samy A，Ali MK，Abbas AM，et al.Randomized controlled trial of the effect of bilateral uterine artery ligation during cesarean among women at risk of uterine atony［J］.Int J Gynaecol Obstet，2020，148（2）：219-224.doi：10.1002/ijgo.13064http://dx.doi.org/10.1002/ijgo.13064.

Yu SC，Cheung EC，Leung VY，et al.Oxytocin-augmented and non-sedating high-intensity-focused ultrasound（hifu）for uterine fibroids showed promising outcome as compared to hifu alone or uterine artery embolization［J］.Ultrasound Med Biol，2019，45（12）：3207-3213.doi：10.1016/j.ultrasmedbio.2019.07.410http://dx.doi.org/10.1016/j.ultrasmedbio.2019.07.410.

单媛媛，黎渊明.血管结扎与栓塞术治疗剖宫产术后子宫收缩乏力性产后出血疗效［J］.中国计划生育学杂志，2020，28（2）：268-271.doi：10.3969/j.issn.1004-8189.2020.02.030http://dx.doi.org/10.3969/j.issn.1004-8189.2020.02.030.

赵立武.双侧子宫动脉上行支结扎联合米索前列醇在产后出血病人中的应用［J］.中国妇幼保健，2018，33（6）：1415-1417.doi：10.7620/zgfybj.j.issn.1001-4411.2018.06.72http://dx.doi.org/10.7620/zgfybj.j.issn.1001-4411.2018.06.72.

Carranco RC，Vigeras A，Ribeiro R，et al.Laparoscopic variants of temporary uterine artery ligation［J］.J Minim Invasive Gynecol，2020，27（4）：811-812.doi：10.1016/j.jmig.2019.08.026http://dx.doi.org/10.1016/j.jmig.2019.08.026.

Sharma B， Sikka P， Jain V， et al. Peripartum hysterectomy in a tertiary care hospital： epidemiology and outcomes［J］.J Anaesthesiol Clin Pharmacol，2017，33（3）：324-328.doi：10.4103/joacphttp://dx.doi.org/10.4103/joacp.

谢妮，周凌云，王毅.子宫动脉上行支结扎术在产后出血高危因素剖宫产术中的预防性应用效果［J］.中国妇幼保健，2021，36（7）：1464-1467.doi：10.19829/j.zgfybj.issn.1001-4411.2021.07.001http://dx.doi.org/10.19829/j.zgfybj.issn.1001-4411.2021.07.001.

刘丹.子宫动脉下行支结扎术与B-Lynch缝合术在前置胎盘所致产后出血中的应用价值［J］.中国妇幼保健，2019，34（13）：3108-3111.doi：10.7620/zgfybj.j.issn.1001-4411.2019.13.64http://dx.doi.org/10.7620/zgfybj.j.issn.1001-4411.2019.13.64.

Washio H，Takeshita D，Sakata S.Parasympathetic nervous activity is associated with oxytocin in multiparous，but not primiparous，women during the perinatal period［J］.Clin Exp Pharmacol Physiol，2020，47（6）：955-965.doi：10.1111/1440-1681.13267http://dx.doi.org/10.1111/1440-1681.13267.

吴笛，龚晨，兰晶，等.胎盘早剥产妇妊娠期止血功能变化特征及其预测产后出血的价值［J］.临床检验杂志，2019，37（9）：661-665.doi：10.13602/j.cnki.jcls.2019.09.05http://dx.doi.org/10.13602/j.cnki.jcls.2019.09.05.

黄红艳，张世应.米索前列醇联合缩宫素对产后出血产妇出血量和凝血功能指标的影响［J］.中国妇幼保健，2020，35（14）：2563-2565.doi：10.19829/j.zgfybj.issn.1001-4411.2020.14.006http://dx.doi.org/10.19829/j.zgfybj.issn.1001-4411.2020.14.006.

Kaya B，Usluogullari B，Yurttutan N，et al.Does ligation of internal iliac artery for postpartum hemorrhage affect clitoral artery blood flow and postpartum sexual functions？［J］.Eur J Obstet Gynecol Reprod Biol，2017，219（1）：124-128.doi：10.1016/j.ejogrb.2017.10.029http://dx.doi.org/10.1016/j.ejogrb.2017.10.029.

吉颖莉，乔艳妮，田玉玉，等.围术期补钙联合地塞米松在剖宫产宫缩乏力性大出血中的价值［J］.中国性科学，2019，28（1）：87-89.doi：10.3969/j.issn.1672-1993.2019.01.026http://dx.doi.org/10.3969/j.issn.1672-1993.2019.01.026.

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