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目的研究对凶险性前置胎盘患者行子宫动脉栓塞术(uterine artery embolization,UAE)的临床应用效果。方法回顾性分析江油市九○三医院产科2013年3月至2016年3月收治的46例凶险型前置胎盘患者的病例资料,根据术中采用的不同处置方式分为两组,两组均采取剖宫术。对照组22例,术中采取常规手段止血;研究组24例,术前进行股动脉穿刺留置预置管至腹主动脉,术中行UAE,亦采取常规方法止血;两组出血情况无法阻止时采取切除子宫。比较两组手术中出血及输血情况、手术耗时、子宫切除率、术后并发症、术后短期及长期恢复情况。结果研究组术中出血量[(562.42±94.12)m L]显著少于对照组[(804.67±124.38)m L];研究组术后24 h出血量[(442.43±124.52)m L]明显少于对照组[(734.56±218.34)m L];研究组输血量[(482.45±26.53)m L]明显少于对照组[(637.56±34.78)m L];研究组的子宫切除率、弥散性血管内凝血发生率、失血休克率显著低于对照组,差异均有统计学意义(P﹤0.05)。结论在凶险型前置胎盘剖宫产中进行UAE,能够减少产妇失血,降低输血用量,减少并发症发生的风险。
Objective To study the clinical effect of uterine artery embolization (UAE) in patients with dangerous placenta previa. Methods The data of 46 cases of dangerous placenta previa placenta admitted from 1990 to March 2016 in Jiangyou 903 Hospital were retrospectively analyzed. The patients were divided into two groups according to the different methods of operation. Take cesarean section. In the control group, 22 cases were treated by conventional means to stop bleeding. In the study group, 24 cases were treated with pre-catheterization of the femoral artery to the abdominal aorta. UAE was performed intraoperatively, and bleeding was also stopped by conventional methods. Cut the uterus. Bleeding and blood transfusion were compared between the two groups. The operation time, hysterectomy, postoperative complications, postoperative short-term and long-term recovery were compared. Results The intraoperative blood loss in the study group was significantly lower than that in the control group [(562.42 ± 94.12) m L [(804.67 ± 124.38) m L]; the amount of bleeding at 24 h after operation in the study group was significantly lower than that of the control group [(442.43 ± 124.52) m L] In the control group [(734.56 ± 218.34) m L], the amount of blood transfusions in the study group [(482.45 ± 26.53) m L] was significantly lower than that in the control group [(637.56 ± 34.78) m L]; the hysterectomy rate The incidence of intravascular coagulation and hemorrhagic shock were significantly lower than those of the control group (P <0.05). Conclusions UAE can be used to reduce the blood loss, reduce the blood transfusion dosage and reduce the risk of complication in cesarean section of dangerous placenta previa.