髂内动脉球囊封堵治疗凶险性前置胎盘的效果及对AFP、HCG水平影响

Efficacy of balloon occlusion of the internal iliac artery for treating pregnant women with dangerous placenta previa, and its influence on levels of AFP and HCGof women

目的:探讨髂内动脉球囊封堵治疗凶险性前置胎盘的效果及对甲胎蛋白(AFP),人绒毛膜促性腺激素(HCG)影响。方法:选取2013年7月-2018年7月本院收治的凶险性前置胎盘患者70例,随机数表法分为观察组(n=36)和对照组(n=34)。观察组采用髂内动脉球囊封堵治疗,对照组使用其他方法止血。比较两组手术情况及血清AFP、HCG、雌二醇(E2)、促黄体生成素(LH)、促卵泡成熟激素(FSH)水平、并发症及月经恢复情况。结果:观察组手术时间(65.34±6.34 min)、阴道流血时间(4.95±1.21 d)及住院时间(7.41±2.45 d)均低于对照组,术中出血量(2071.3±301.3ml)、术中输血量(1356.3±215.4ml)及产后24h出血量(2080.1±112.4ml)均低于对照组(均P<0.05);治疗后两组性激素水平均改善,且观察组E2水平高于对照组,AFP、HCG、LH、FSH水平低于对照组,并发症总发生率(13.9%)低于对照组(44.1%),月经恢复时间(54.2±11.2d)短于对照组(均P<0.05)。结论:髂内动脉球囊封堵在凶险性前置胎盘中应用效果显著,可有效改善患者术中术后出血,降低AFP、HCG水平,缩短月经恢复时间,改善性激素水平。

Objective:To explore the efficacy of balloon occlusion of the internal iliac artery for treating pregnant women with dangerous placenta previa,and to study its influence on levels of Alpha-fetoprotein(AFP),human chorionic gonadotropin(HCG)of women.Methods:70 pregnant women with dangerous placenta previa were selected and were divided into observation group(n=36)and control group(n=34)from July 2013 to July 2018.The women in the control group were treated by non-uterine artery embolization,while the women in the observation group were treated by balloon occlusion of internal iliac artery.The operative situation,levels of estradiol(E2),luteinizing hormone(LH),and follicle stimulating hormone(FSH),rate of complications,and menstruation recovery situation of women were compared between the two groups.Results:The operation time,vaginal bleeding time,and hospital stay,intraoperative blood loss volum,intraoperative blood transfusion volum,and postpartum blood loss volum of women in the observation group were 65.34±6.34 min,4.95±1.21 d,7.41±2.45 d,2071.3±301.3 ml,1356.3±215.4 ml,and 2080.1±112.4 ml,which were significant lower than those of women in the control group(P<0.05).After treatment,the levels of sex hormones of women in both groups had significantly improved.E2 level of women in the observation group was significant higher than that of women in the control group,but the levels of AFP and HCG,LH and FSH of women in the observation group were significant lower(P<0.05).The total incidence of complications of women in the observation group was was 13.9%,which was significant lower than that(44.1%)of women in the control group(P<0.05).Menstruation recovery time of women in the observation group was 54.2±11.2 d,which was significant shorter than that of women in the control group(P<0.05).Conclusion:The balloon occlusion of internal iliac artery used for treating women with dangerous placenta previa has good effectiveness,which can effectively improve the levels of AFP and HCG,shorten menstrual recovery time,and improve hormone level of women.