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目的:探讨凶险型前置胎盘不同阶段介入栓塞治疗的可行性及临床应用价值。方法:回顾分析47例凶险型前置胎盘患者的临床资料,其中剖宫产分娩后大出血急诊行介入栓塞治疗者31例(A组),分娩前置入动脉鞘出血再行介入栓塞治疗者9例(B组),分娩前置入动脉鞘、胎盘娩出前先行介入栓塞治疗者7例(C组)。比较3组患者的平均出血量、输血量、最低血压及出院时间。结果:C组患者的平均出血量、输血量、住院时间均显著低于A、B组(P<0.01),B组显著低于A组(P<0.01)。C组患者平均最低血压显著高于A、B组(P<0.01),B组显著高于A组(P<0.01)。结论:分娩前置入动脉鞘,胎盘娩出前先行介入栓塞治疗能有效地减少凶险型前置胎盘患者的出血量,显著降低失血性休克的发生,明显缩短出院时间。
Objective: To investigate the feasibility and clinical value of embolization in different stages of dangerous placenta previa. Methods: A retrospective analysis of 47 cases of dangerous placenta previa patients with clinical data, including cesarean section postpartum hemorrhage emergency interventional embolization in 31 patients (group A), before delivery into the arterial sheath hemorrhage and then interventional embolization 9 Cases (group B), before insertion into the arterial sheath, placenta embolization before intervention in 7 cases (group C). The mean blood loss, blood transfusion, minimum blood pressure and discharge time were compared between the three groups. Results: The average amount of blood loss, blood transfusion and hospital stay in group C were significantly lower than those in groups A and B (P <0.01), and in group B was significantly lower than that in group A (P <0.01). The mean minimum blood pressure of group C was significantly higher than that of group A and B (P <0.01), while that of group B was significantly higher than that of group A (P <0.01). Conclusion: The arterial sheath placed before delivery and the placenta inserted before embolization can effectively reduce the amount of bleeding in patients with aggressive placenta previa, significantly reduce the incidence of hemorrhagic shock and significantly shorten the discharge time.