胎盘前置引产术前子宫动脉栓塞治疗的临床效果

Clinical Effect of Placenta Previa Induced Labor of Preoperative Uterine Artery Embolization

目的探讨对胎盘前置妊娠妇女引产术前采用子宫动脉栓塞治疗的临床效果及安全性,为临床上胎盘前置妊娠妇女安全引产提供参考方法。方法回顾性分析在作者医院产科进行引产术的22例胎盘前置妊娠中期要求终止妊娠的孕妇(胎盘前置组)及同期无胎盘前置要求终止妊娠孕妇(对照组)20例。处理组胎盘前置组行子宫动脉栓塞术,术后12 h无宫缩,与对照组均注射100 mg依沙吖啶到羊膜腔,记录并比较两组临产时间、产程、失血量、引产术前后的血常规、恶露持续时间、月经恢复时间、子宫复旧情况以及相关并发症的发生情况。结果在成功引产、平均产程、诱发临产时间、术中出血量、血红蛋白(hemoglobin,Hb)差值、术后发热、术后下肢及腰腹疼痛、尿潴留、红细胞压积(hematokrit,HCT)差值、平均住院时间、恶露持续时间、月经恢复时间这12项指标中,胎盘前置组与对照组平均产程、诱发临产时间、术后发热这三项指标存在明显差异(P<0.05),胎盘前置组为发热(10例)、平均产程(589±321)min,明显高于对照组的2例和(268±161)min,诱发临产时间胎盘前置组为(1184±821)min,明显低于对照组的(1813±1121)min(χ2=7.333,t=4.032,t=2.088,P<0.05),其他指标两组比较无明显差异(P>0.05)。结论对胎盘前置妊娠妇女引产术前采用子宫动脉栓塞治疗具有较高的安全性,成功率较高。

Objective To explore the clinical effect and safety of preoperative uterine artery embolization in preg- nant women with placenta previa, provide a reference for the clinical safety of placenta previa pregnant women in labor. Methods A retrospective analysis of 22 cases of placenta previa during mid trimester of pregnancy induced labor operation in our hospital to terminate pregnancy （placenta previa group） and the control group at the same period without pla centa previa required termination of pregnancy （20 cases） was performed. Placenta previa group underwent uterine artery embolization and had no uterine contraction 12 h after operation. The control groups were injected 100mg rivanol into amniotic cavity. Labor, labor time, amount of bleeding during operation, the blood routine induction of labor, lochia,men- strual recovery time, the duration of uterine involution and related complications were recorded and compared between the two groups.Results Among 12 indicators including the successful induction of labor, the average labor, induced labor time, amount of bleeding, Hb difference, postoperative fever, postoperative lower limb and abdominalpain, urinary re- tention, hematokrit difference, the average hospitalization time,prolonged duration, menstrual recovery time, the average labor, induced labor time, postoperative fever in the three indicators of placenta previa group and control group had significant difference （P〈0.05） . The main complications in placenta previa group were fever （1（） cases） and the average la bor time was （589 ± 321） min, significantly higher than 2 cases an （268±161 ） min in the control group. The induced la- bor time was （1184 ±821 ） min in placenta previa group, significantly lower than （1813 ±1121 ） rain in the control group. The other indicators Between two groups had no significant difference （P 〉0.65 ）. Conclusion The preoperative use of uterine artery embolization for the treatment of placenta previa pregnant women has high security and success rate.