子宫动脉插管化疗栓塞术治疗产后胎盘植入伴感染

Uterine artery chemoembolization in treatment of patients with postpartum placenta implantation and infection

目的 探讨子宫动脉插管化疗栓塞术（UACE）治疗产后胎盘植入伴感染的临床疗效。方法 采用UACE治疗12例产后胎盘植入伴感染的患者,并评价治疗效果。结果 12例患者均顺利完成手术,术后彩色多普勒超声检查示胎盘植入区域血流灌注明显减少甚至消失,人绒毛膜促性腺激素（HCG）较入院时有显著下降（P〈0.002）,其中6例患者7天内胎盘组织自行排出,5例患者接受辅助清宫术。术后随访3~34个月,所有患者均未出现介入治疗相关的远期并发症,患者均月经复潮,其中1例患者再次妊娠。结论 UACE是治疗产后胎盘植入伴感染的一种微创有效的治疗方法。

Objective To explore the clinical effect of uterine artery chemoembolization （UACE） in treatment of patients with postpartum placenta implantation and infection. Methods Totally 12 patients with postpartum placenta implantation and infection in patients underwent UACE, and therapeutic effect were evaluated. Results All of 12 patients were success- fully completed surgery. Color doppler ultrasound showed perfusion was significantly reduced or even disappear in placenta increta region. Postoperative human chorionic gonadotropin （HCG） decreased significantly, compared with preoperative HCG （P〈0. 002）. Placenta tissue spontaneously discharged in 6 patients within 7 days and 5 patients underwent curettage of uterus. Following up 3--34 months, all patients were not present intervention related to long-term complications and had restored menstruation including 1 case of pregnancy again. Conclusion UACE in treatment of postpartum placenta implan- tation and infection is a minimally invasive and effective.