经导管髂内动脉栓塞术治疗产后出血的护理方法及预后分析
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摘要
目的探讨经导管髂内动脉栓塞术治疗产后出血的护理方法及预后分析。方法选取该院于2017年9月—2018年6月收治的30例经保守治疗无效的难治性产后出血患者为研究对象。所有患者均因产后出血行经导管髂内动脉栓塞术,在治疗期间即术前和术后给予患者综合护理,观察护理效果。结果 30例患者中有27例患者经髂内动脉栓塞后出血立即停止,血压逐渐回升,生命体征逐渐稳定;3例患者术后出血明显减少,采取相应护理措施后出血停止。18例患者术后发生相关并发症,其中下腹隐痛3例,下肢疼痛1例,恶心呕吐4例,轻度发热11例。所有患者皆已康复出院,随访至今,目前还未发现再出血。结论经导管髂内动脉栓塞术治疗产后出血可及时有效止血,临床效果良好,给予患者综合护理有利于患者预后,提高栓塞术临床疗效。
Objective To study the nursing method and prognosis of transcatheter internal iliac artery embolization in treatment of postpartum hemorrhage. Methods 30 cases of patients with intractable postpartum hemorrhage after the conservative therapy admitted and treated in our hospital from September 2017 to June 2018 were selected, all patients were for transcatheter internal iliac artery embolization due to postpartum hemorrhage, during the treatment period, all patients were for general nursing and the nursing effect was observed. Results Of 30 cases, the bleeding of 27 cases stopped immediately after the internal iliac artery embolization, and the blood pressure gradually increased, and the vital signs gradually became steady, and the postoperative hemorrhage of 3 cases obviously decreased, and the bleeding of them stooped after the corresponding nursing measures, and 18 cases had the related complications, including 3 cases with lower abdominal pain, 1 case with pains of lower extremities, 4 cases with vomiting and nausea, and 11 cases with mild fever, all patients were discharged after rehabilitation, and all patients had the rebleeding. Conclusion The transcatheter internal iliac artery embolization in treatment of postpartum hemorrhage can effectively stop the bleeding,and the clinical effect is good, and the comprehensive nursing of patients is conductive to the prognosis of patients and improve the clinical curative effect of embolization.
Objective To study the nursing method and prognosis of transcatheter internal iliac artery embolization in treatment of postpartum hemorrhage. Methods 30 cases of patients with intractable postpartum hemorrhage after the conservative therapy admitted and treated in our hospital from September 2017 to June 2018 were selected, all patients were for transcatheter internal iliac artery embolization due to postpartum hemorrhage, during the treatment period, all patients were for general nursing and the nursing effect was observed. Results Of 30 cases, the bleeding of 27 cases stopped immediately after the internal iliac artery embolization, and the blood pressure gradually increased, and the vital signs gradually became steady, and the postoperative hemorrhage of 3 cases obviously decreased, and the bleeding of them stooped after the corresponding nursing measures, and 18 cases had the related complications, including 3 cases with lower abdominal pain, 1 case with pains of lower extremities, 4 cases with vomiting and nausea, and 11 cases with mild fever, all patients were discharged after rehabilitation, and all patients had the rebleeding. Conclusion The transcatheter internal iliac artery embolization in treatment of postpartum hemorrhage can effectively stop the bleeding,and the clinical effect is good, and the comprehensive nursing of patients is conductive to the prognosis of patients and improve the clinical curative effect of embolization.
引文
[1]薛志琴.产后出血的危险因素分析与防控策略探讨[J].基因组学与应用生物学,2018,37(2):513-518.
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[4]Cheng H H,Tsang L L,Hsu T Y,et al.Transcatheter arterial embolization as first-line rescue in intractable primary postpartum hemorrhage:Assessment,outcome,and subseq ue nt fertility[J].Journal of the Formosan Medical Association=Taiwan yi zhi,2017,116(5):380-7.
[5]郑昭.优质护理服务在宫缩乏力性产后出血中的应用效果[J].中外女性健康研究,2018(5):161,163.
[6]汪文娟.不同治疗方法对产后出血患者的影响及疗效对比分析[J].中国医药科学,2016,6(16):101-103,210.
[7]梁致怡,苏继颖,李政,等.介入治疗预防合并胎盘异常的中晚期妊娠产后出血应用[J].中国计划生育学杂志,2017,25(4):285-288.
[8]Donmez H,Ozturk M H,Gurgen F,et al.Intractable postpartum hemorrhage resulting from uterine artery pseudoaneurysm:superselective arteriographic embolization via the collateral route[J].Cardiovascular and interventio nal radiology,2007,30(2):310-2.
[9]Hunter L A.Exploring the role of uterine artery embolization in the management of postpartum hemorrhage[J].The Journal of perinatal&neonatal nursing,2010,24(3):207-14.
[10]陈伟君,梅海炳,何忠威,等.髂内动脉栓塞术治疗产后大出血[J].介入放射学杂志,2001(1):11-12.
[2]刘娟,董晋,张春莉,等.产后出血原因及高危因素临床研究[J].陕西医学杂志,2018,47(7):871-873.
[3]刘会芹,赵润果,王芳,等.产后出血相关危险因素分析与治疗方法比较[J].河北医药,2018,40(5):748-751.
[4]Cheng H H,Tsang L L,Hsu T Y,et al.Transcatheter arterial embolization as first-line rescue in intractable primary postpartum hemorrhage:Assessment,outcome,and subseq ue nt fertility[J].Journal of the Formosan Medical Association=Taiwan yi zhi,2017,116(5):380-7.
[5]郑昭.优质护理服务在宫缩乏力性产后出血中的应用效果[J].中外女性健康研究,2018(5):161,163.
[6]汪文娟.不同治疗方法对产后出血患者的影响及疗效对比分析[J].中国医药科学,2016,6(16):101-103,210.
[7]梁致怡,苏继颖,李政,等.介入治疗预防合并胎盘异常的中晚期妊娠产后出血应用[J].中国计划生育学杂志,2017,25(4):285-288.
[8]Donmez H,Ozturk M H,Gurgen F,et al.Intractable postpartum hemorrhage resulting from uterine artery pseudoaneurysm:superselective arteriographic embolization via the collateral route[J].Cardiovascular and interventio nal radiology,2007,30(2):310-2.
[9]Hunter L A.Exploring the role of uterine artery embolization in the management of postpartum hemorrhage[J].The Journal of perinatal&neonatal nursing,2010,24(3):207-14.
[10]陈伟君,梅海炳,何忠威,等.髂内动脉栓塞术治疗产后大出血[J].介入放射学杂志,2001(1):11-12.