摘要目的:探讨经导管动脉栓塞术治疗难治性产后出血的效果。方法:抽取2020年6月至2022年6月河南神火集团总医院收治的难治性产后出血患者82例，按随机数字表法分为对照组和观察组，每组41例。对照组予以子宫切除术治疗，观察组予以经导管动脉栓塞术治疗。比较两组止血成功率、围术期指标、血清性激素水平、卵巢动脉血流及并发症发生情况。结果:两组止血成功率比较差异未见统计学意义( P>0.05)。观察组手术时间[(39.85±4.16)min]、术后下床活动时间[(2.89±0.35)d]及住院时间[(7.89±1.12)d]短于对照组[(78.69±7.25)min、(4.63±0.78)d、(9.67±1.25)d]， P<0.05。术后，观察组雌二醇[(53.41±5.12)pg/ml]低于对照组[(57.63±5.23)pg/ml]，促黄体生成素[(12.86±1.32)mIU/ml]、卵泡刺激素[(9.58±1.14)mIU/ml]高于对照组[(10.59±1.22)、(7.08±1.05)mIU/ml]， P<0.05。术后，观察组卵巢动脉阻力指数(0.83±0.14)、搏动指数(1.23±0.24)低于对照组(0.91±0.16、1.36±0.27)， P<0.05。观察组并发症发生率低于对照组，差异有统计学意义( P<0.05)。 结论:经导管动脉栓塞术治疗难治性产后出血效果更佳，可降低对卵巢动脉血流的影响，且并发症少。

abstractsObjective:To investigate the effects of transcatheter arterial embolization on refractory postpartum hemorrhage.Methods:A total of 82 patients with refractory postpartum hemorrhage admitted to Sunho General Hospital from June 2020 to June 2022 were selected, and the patients were divided into control group and observation group according to the random number table method, with 41 cases in each group. The control group was treated by hysterectomy, and the observation group was treated by transcatheter arterial embolization. The success rate of hemostasis, perioperative indicators, levels of serum sex hormones, ovarian artery blood flow, and complications were compared between the two groups.Results:There was no significant difference in the success rate of hemostasis between the two groups ( P>0.05). The operation time, postoperative out-of-bed time and hospital stay of the observation group were (39.85±4.16) min, (2.89±0.35) d and (7.89±1.12) d, respectively, which were shorter the (78.69±7.25) min, (4.63±0.78) d, (9.67±1.25) d of the control group ( P<0.05). After operation, the estradiol of the observation group was (53.41±5.12) pg/ml, lower than the (57.63±5.23) pg/ml of the control group, while the luteinizing hormone and follicle stimulating hormone in the observation group were (12.86±1.32) mIU/ml and (9.58±1.14) mIU/ml, respectively, which were higher than the (10.59±1.22) mIU/ml and (7.08±1.05) mIU/ml in the control group ( P<0.05). After operation, the ovarian artery resistance index (0.83±0.14) and pulsatility index (1.23±0.24) of the observation group were lower than those of the control group (0.91±0.16, 1.36±0.27), P<0.05. The incidence of complications in the observation group was lower than that in the control group, and the difference was statistically significant ( P<0.05). Conclusions:Transcatheter arterial embolization is more effective in the treatment of refractory postpartum hemorrhage, and can reduce the impact on ovarian artery blood flow, with fewer complications.