子宫动脉栓塞术在穿透性凶险性前置胎盘中的临床应用研究

Clinical Research of Uterine Artery Embolization in Pernicious Placenta Previa Complicated with Placenta Percreta

目的:探讨子宫动脉栓塞术在穿透性凶险性前置胎盘中的临床应用效果。方法:选取2010年1月~2014年12月唐山市妇幼保健院收治的孕晩期穿透性凶险性前置胎盘患者36例,依据是否行子宫动脉栓塞术分为子宫动脉栓塞组20例和非子宫动脉栓塞组16例,比较两组患者的术中情况和临床结局。结果:子宫动脉栓塞组患者失血量、红细胞输血量、冷沉淀输血量均少于非子宫动脉栓塞组(P<0.05)。两组患者血浆输血量和术后住院时间比较差异无统计学意义(P>0.05)。子宫动脉栓塞组ICU入住率、子宫切除率、产后出血、DIC发生率均低于非子宫动脉栓塞组(P<0.05)。两组患者的产褥感染率、失血性休克发生率、早产儿发生率以及新生儿轻度窒息率比较差异均无统计学意义(P>0.05)。结论:子宫动脉栓塞术可以减少术中出血及术后并发症的发生率,改善穿透性凶险性前置胎盘的临床结局。

Objective：To explore the clinical effect of uterine artery embolization in pernicious placenta previa complicated with placenta percreta.Methods：36 patients with pernicious placenta previa complicated with placenta percreta who were treated in Tangshan Health Center for Women and Children from January 2010 to December 2014 were selected,they were divided into uterine artery embolization group with 20 cases and non uterine artery embolization group with 16 cases,compared the intraoperative conditions and clinical outcomes of two groups.Results：The amount of blood loss,red blood cell transfusion and blood transfusion in the uterine artery embolization group were less than those in the non uterine artery embolization group（P〈0.05）,there was no significant difference in the amount of blood transfusion and postoperative hospital stay between the two groups（P〉0.05）.ICU occupancy rate,uterine resection rate,postpartum hemorrhage,incidence of DIC in uterine artery embolization group were lower than that of non uterine artery embolization group（P〈0.05）,there was no significant difference in puerperal infection rate and hemorrhagic shock rate,premature birth rate and mild neonatal asphyxia rate between the two groups（P〉0.05）.Conclusion：Uterine artery embolization can reduce the incidence of intraoperative bleeding and postoperative complications and improve the clinical outcome of pernicious placenta previa complicated with placenta percreta.