介入治疗胎盘植入产后出血的临床分析

The clinical analysis of interventional therapy on placenta increta with puerperal hemorrhage

目的探讨植入性胎盘介入治疗的有效性及安全性。方法2005年7月—2007年7月本院收治9例胎盘植入患者,以病变侧子宫动脉灌注甲氨喋呤+栓塞的方法治疗。观察治疗效果及预后情况,并记录不良反应。结果9例产前或大出血前均未明确诊断,行子宫动脉栓塞,除2例剖宫产局部病灶切除者外,余7例1周后行刮宫术,无1例再次大出血,9例均保留了子宫。结论介入治疗胎盘植入疗效较好、方法简单、不良反应小、成功率高,是首选的、行之有效的治疗方法。

Objective To investigate the effectiveness and safety of interventional treatment on placenta increta. Methods 9 cases of placental increta from July 2005 to July 2007 were retrospectively analysed, All patients was treated with uterine arterial infusion of methotrexate（ MTX, 75 mg） combined with embolization. The therapeutic effect, prognosis and side effect were observed and analyzed. Results 9 patients underwent uterine artery embolization （UAE）, which didn＇t diagnose definitely before induced abortion or heavily hemorrhage. 7 of them underwent curettage after UAE. None of them had heavily hemorrhage and hysterectomy. Conclusion It showed that interventional therapy with uterine arterial embolization was a simple, effective method with highly successful rate and little side effect for treatment of placenta increta. It could be used as the first choice in treating patients with placenta increta.