单纯子宫动脉栓塞术治疗阴道分娩后胎盘植入的疗效分析

Efficacy of simple uterine artery embolization in the treatment of placenta accreta after vaginal delivery

目的评估针对阴道分娩后胎盘植入实施单纯子宫动脉栓塞术治疗的临床疗效。方法回顾性分析2017年1月至2021年12月福建省妇幼保健院阴道分娩后胎盘植入患者33例为研究对象,其中患者年龄(31.21±3.64)岁,孕次(3.21±0.68)次,产次(0.79±0.12)次。观察阴道分娩后胎盘植入患者诊断时机、产前处理、产时处理、产后处理、人绒毛膜促性腺激素(HCG)恢复正常时间,并对比患者治疗前后生活质量变化情况。采用配对t检验。结果33例患者在产前、产时、产后不同阶段均根据其实际患病情况展开了针对性的治疗与干预,其HCG恢复正常时间为(35.24±6.13)d。治疗后患者生理职能[(81.09±3.17)分]、精神状态[(81.16±4.25)分]、总体健康[(81.34±3.07)分]、活力[(81.29±4.22)分]、躯体疼痛[(83.48±3.08)分]、生理功能[(81.56±4.35)分]、情感职能[(81.54±4.27)分]、社会功能评分[(81.88±3.52)分]均高于治疗前[(73.24±4.55)分、(73.17±3.87)分、(73.28±5.43)分、(73.44±4.87)分、(75.49±5.27)分、(73.15±4.88)分、(74.28±3.48)分、(74.48±3.84)分],差异均有统计学意义(t=8.131、7.985、7.422、6.997、7.519、7.390、7.571、8.160,均P<0.001)。结论单纯子宫动脉栓塞术在对阴道分娩后胎盘植入患者实施治疗时,能够产生理想的临床疗效,可优化生活质量,值得推广应用。

Objective To evaluate the clinical efficacy of simple uterine artery embolization for placenta accreta after vaginal delivery.Methods A total of 33 patients with placenta accreta after vaginal delivery in Fujian Maternal and Child Health Hospital from January 2017 to December 2021 were retrospectively selected as the subjects,with an age of(31.21±3.64)years old,the number of pregnancies of(3.21±0.68),and the number of births of(0.79±0.12).The diagnosis timing,prenatal management,intrapartum management,postpartum management,and recovery time of human chorionic gonadotropin(HCG)were observed for the patients with placenta accreta after vaginal delivery.The patients'qualities of life before and after treatment were compared.Paired t test was used.Results The 33 patients received targeted treatment and intervention according to their actual disease conditions at different stages of prenatal,intrapartum,and postpartum,and the time for HCG returning to normal was(35.24±6.13)d.After treatment,the patients'scores of physiological function[(81.09±3.17)points],mental state[(81.16±4.25)points],overallhealth[(81.34±3.07)points],vitality[(81.29±4.22)points],somaticpain[(83.48±3.08)points],physiological function[(81.56±4.35)points],emotional function[(81.54±4.27)points],and social function[(81.88±3.52)points]were higher than those before treatment[(73.24±4.55)points,(73.17±3.87)points,(73.28±5.43)points,(73.44±4.87)points,(75.49±5.27)points,(73.15±4.88)points,(74.28±3.48)points,and(74.48±3.84)points],with statistically significant differences(t=8.131,7.985,7.422,6.997,7.519,7.390,7.571,and 8.160;all P<0.001).Conclusion Simple uterine artery embolization can produce ideal clinical efficacy in the treatment of patients with placenta accreta after vaginal delivery,and optimize the quality of life,so it is worthy of popularization and application.