16例中期妊娠前置胎盘状态介入治疗的护理

Nursing care for patients with placenta previa undergoing interventional therapy in the second trimester of pregnancy

目的探讨中晚期妊娠前置胎盘状态行介入治疗的护理特点。方法栓塞治疗16例中晚期妊娠前置胎盘状态患者时同时应用利凡诺羊膜腔注射引产治疗,术前、术中、术后予以严密的观察和护理。总结该病护理特点。结果16例中晚期妊娠前置胎盘状态患者中,15例术后平均4.5h胎儿及其附属组织娩出,无产后出血。1例孕26周因瘢痕子宫、有宫颈性难产史引产失败,在栓塞术后第6天行剖宫取胎术,术中出血约100ml。16例患者均未发生护理并发症。结论子宫动脉栓塞术应用在中晚期妊娠前置胎盘出血引产中,疗效可靠。同时加强术前、术中、术后的护理,可以提高介入治疗的成功率,预防并发症的发生。

Objective To discuss the nursing care for patients with placenta previa, who receive uterine arterial catheterization and embolization in the second trimester of pregnancy. Methods By using superselective catheterization with Seldinger technique, bilateral uterine artery angiography and emholization were performed in 16 patients with placenta previa in the second trimester of pregnancy. Two to four hours after the procedure, rivanol intra-amniotie injection was employed to induce the abortion. Close perioperative observation and careful nursing were carried out. Results The fetus with its subsidiary tissue was delivered in a mean time of 4.5 hours after the operation in 15 cases. No postpartum hemorrhage occurred. Induced abortion failed in one case with 26 weeks pregnancy because of a scar uterus and cervical dystoeia. Hysterotomy was performed 6 days later, blood loss during the operation was about 100 ml. No nursing care related complications occurred in all 16 patients. Conclusion Uterine arterial embolization is very helpful in making the induced abortion for the treatment of bleeding placenta previa in the second trimester of pregnancy. Strengthening of perioperative care can improve successful rate of interventional therapy and prevent the occurrence of complication.