目的探讨凶险性前置胎盘剖宫产术中腹主动脉球囊阻断时机的选择对术中、术后出血以及子宫切除率的影响。方法选取2017年1月至2019年10月期间绵阳市第三人民医院产科收治的92例凶险性前置胎盘患者作为研究对象,根据球囊阻断的时机分组,其...目的探讨凶险性前置胎盘剖宫产术中腹主动脉球囊阻断时机的选择对术中、术后出血以及子宫切除率的影响。方法选取2017年1月至2019年10月期间绵阳市第三人民医院产科收治的92例凶险性前置胎盘患者作为研究对象,根据球囊阻断的时机分组,其中52例于剖宫产术中切开子宫肌层的同时行球囊阻断(观察组),40例在胎儿娩出后行球囊阻断(对照组)。比较两组患者的手术相关指标(手术时间、术中出血量、术中红细胞悬浊液输入量、子宫切除率),新生儿预后(1 min Apgar评分、5 min Apgar评分),术后恢复情况(产后出血发生率、转ICU率、术后住院时间),以及并发症发生情况。结果观察组患者的手术时间、术中出血量、术中输入红细胞悬浊液量分别为(97.35±14.18)min、(746.73±354.68)mL、(1.73±1.52)U,少于对照组的(118.52±21.63)min、(925.86±407.53)mL、(3.18±1.26)U,差异均有统计学意义(P<0.05);观察组患者的子宫切除率为1.92%,与对照组的2.50%比较差异无统计学意义(P>0.05);观察组新生儿娩出1 min Apgar评分、5 min Apgar评分分别为(9.51±1.46)分、(9.44±1.32)分,对照组分别为(9.92±0.53)分、(9.83±0.75)分,两组比较差异均无统计学意义(P>0.05);观察组和对照组患者术后住院时间分别为(5.35±1.42)d、(5.82±1.79)d,差异无统计学意义(P>0.05);观察组产后出血发生率、转ICU率分别为7.69%、5.77%,明显低于对照组的22.50%、20.00%,差异均有统计学意义(P<0.05);观察组患者术后并发症发生率为3.85%,与对照组的2.50%比较差异无统计学意义(P>0.05)。结论凶险性前置胎盘剖宫产术中切开子宫肌层同时行球囊阻断,与胎儿娩出后实施阻断比较,更有利于控制术中、术后出血,且不会增加新生儿窒息风险。展开更多
Objective: To assess the outcomes of patients who underwent uterine fibroid embolization (UFE) and to evaluate factors associated with failure of UFE. Design: Retrospective study. Setting: University teaching hospital...Objective: To assess the outcomes of patients who underwent uterine fibroid embolization (UFE) and to evaluate factors associated with failure of UFE. Design: Retrospective study. Setting: University teaching hospital. Patient(s): Two hundred thirty-three consecutive patients who underwent UFE from November 1997 to February 2004. Intervention(s): Uterine fibroid embolizations were performed by three interventional radiologists using 355-500-μpolyvinyl alcohol particles. Main Outcome Measure(s): Hysterectomy rate, myomectomy rate, and repeat UFE rate. Result(s): With a mean follow-up of 13 months, a total of 22 patients underwent surgery after UFE (9.4%); 16 had hysterectomies (6.9%), and 6 had myomectomies (2.6%). This included 3 patients who underwent repeat UFE and subsequently required surgical intervention. The mean (±SEM) time interval between UFE and subsequent treatment was 12.5 ±2.0 months. Among patients who required surgery, 13 (59.1%) presented with recurrent menorrhagia, and 5 (22.7%) complained of persistent abdominal pain. Histopathologic examination revelead concomitant findings of adenomyosis in 25%of hysterectomy specimens. Patients who failed UFE were more likely to have had a previous myomectomy (13%vs 2.4%) and significant reduction in the uterine size 6 months after UFE (57.1%vs 25.2%). Conclusion(s): The overall failure rate of UFE is 9.4%. Failure is mainly due to persistent menorrhagia and abdominal pain. Shrinkage of the uterus after UFE does not necessarily correlate with long-term success of UFE.展开更多
文摘目的探讨凶险性前置胎盘剖宫产术中腹主动脉球囊阻断时机的选择对术中、术后出血以及子宫切除率的影响。方法选取2017年1月至2019年10月期间绵阳市第三人民医院产科收治的92例凶险性前置胎盘患者作为研究对象,根据球囊阻断的时机分组,其中52例于剖宫产术中切开子宫肌层的同时行球囊阻断(观察组),40例在胎儿娩出后行球囊阻断(对照组)。比较两组患者的手术相关指标(手术时间、术中出血量、术中红细胞悬浊液输入量、子宫切除率),新生儿预后(1 min Apgar评分、5 min Apgar评分),术后恢复情况(产后出血发生率、转ICU率、术后住院时间),以及并发症发生情况。结果观察组患者的手术时间、术中出血量、术中输入红细胞悬浊液量分别为(97.35±14.18)min、(746.73±354.68)mL、(1.73±1.52)U,少于对照组的(118.52±21.63)min、(925.86±407.53)mL、(3.18±1.26)U,差异均有统计学意义(P<0.05);观察组患者的子宫切除率为1.92%,与对照组的2.50%比较差异无统计学意义(P>0.05);观察组新生儿娩出1 min Apgar评分、5 min Apgar评分分别为(9.51±1.46)分、(9.44±1.32)分,对照组分别为(9.92±0.53)分、(9.83±0.75)分,两组比较差异均无统计学意义(P>0.05);观察组和对照组患者术后住院时间分别为(5.35±1.42)d、(5.82±1.79)d,差异无统计学意义(P>0.05);观察组产后出血发生率、转ICU率分别为7.69%、5.77%,明显低于对照组的22.50%、20.00%,差异均有统计学意义(P<0.05);观察组患者术后并发症发生率为3.85%,与对照组的2.50%比较差异无统计学意义(P>0.05)。结论凶险性前置胎盘剖宫产术中切开子宫肌层同时行球囊阻断,与胎儿娩出后实施阻断比较,更有利于控制术中、术后出血,且不会增加新生儿窒息风险。
文摘Objective: To assess the outcomes of patients who underwent uterine fibroid embolization (UFE) and to evaluate factors associated with failure of UFE. Design: Retrospective study. Setting: University teaching hospital. Patient(s): Two hundred thirty-three consecutive patients who underwent UFE from November 1997 to February 2004. Intervention(s): Uterine fibroid embolizations were performed by three interventional radiologists using 355-500-μpolyvinyl alcohol particles. Main Outcome Measure(s): Hysterectomy rate, myomectomy rate, and repeat UFE rate. Result(s): With a mean follow-up of 13 months, a total of 22 patients underwent surgery after UFE (9.4%); 16 had hysterectomies (6.9%), and 6 had myomectomies (2.6%). This included 3 patients who underwent repeat UFE and subsequently required surgical intervention. The mean (±SEM) time interval between UFE and subsequent treatment was 12.5 ±2.0 months. Among patients who required surgery, 13 (59.1%) presented with recurrent menorrhagia, and 5 (22.7%) complained of persistent abdominal pain. Histopathologic examination revelead concomitant findings of adenomyosis in 25%of hysterectomy specimens. Patients who failed UFE were more likely to have had a previous myomectomy (13%vs 2.4%) and significant reduction in the uterine size 6 months after UFE (57.1%vs 25.2%). Conclusion(s): The overall failure rate of UFE is 9.4%. Failure is mainly due to persistent menorrhagia and abdominal pain. Shrinkage of the uterus after UFE does not necessarily correlate with long-term success of UFE.
