阴道分娩后胎盘植入治疗的研究进展

Progress in Treatment of Placenta Accreta after Vaginal Delivery

近年来,随着剖宫产、子宫肌瘤剔除术、人工流产等子宫手术的增加,胎盘植入的发生率也随之增加。目前胎盘植入可选择的治疗方式越来越多,除传统的子宫切除外,根据胎盘植入的面积及程度、产时产后出血量的不同可采取个体化治疗方案,包括药物治疗、高强度聚焦超声、子宫动脉化疗栓塞、保守性手术治疗等,以改善患者临床症状,减少产后出血量、感染等并发症的发生,降低子宫切除率及病死率。但目前针对胎盘植入在阴道分娩后不同治疗方式的应用指征尚不明确,因此深入探讨不同治疗方式的适应证及禁忌证,可为胎盘植入的治疗提供参考。

In recent years,with the increase of uterine operations such as Cesarean section,hysteromyomectomy and induced abortion,the incidence of placenta accreta also increases.At present,there are more and more different treatment options for placenta accrete.In addition to the traditional hysterectomy,individualized treatment schemes,including medication,high-intensity focused ultrasound,uterine artery chemoembolization,conservative surgical treatment etc.,can be adopted according to the area and degree of placenta accreta,the amount of parturition and postpartum hemorrhage,so as to improve the patient′s clinical symptoms,reduce postpartum hemorrhage,infection and other complications,and decrease the rate of uterine resection and case fatality.However,the indications for different treatment methods are still unclear,therefore,further exploration of the indications and contraindications of different treatment methods can provide reference for the treatment of placenta accreta.