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目的探讨对胎盘前置妊娠妇女引产术前采用子宫动脉栓塞治疗的临床效果及安全性,为临床上胎盘前置妊娠妇女安全引产提供参考方法。方法回顾性分析在作者医院产科进行引产术的22例胎盘前置妊娠中期要求终止妊娠的孕妇(胎盘前置组)及同期无胎盘前置要求终止妊娠孕妇(对照组)20例。处理组胎盘前置组行子宫动脉栓塞术,术后12 h无宫缩,与对照组均注射100 mg依沙吖啶到羊膜腔,记录并比较两组临产时间、产程、失血量、引产术前后的血常规、恶露持续时间、月经恢复时间、子宫复旧情况以及相关并发症的发生情况。结果在成功引产、平均产程、诱发临产时间、术中出血量、血红蛋白(hemoglobin,Hb)差值、术后发热、术后下肢及腰腹疼痛、尿潴留、红细胞压积(hematokrit,HCT)差值、平均住院时间、恶露持续时间、月经恢复时间这12项指标中,胎盘前置组与对照组平均产程、诱发临产时间、术后发热这三项指标存在明显差异(P<0.05),胎盘前置组为发热(10例)、平均产程(589±321)min,明显高于对照组的2例和(268±161)min,诱发临产时间胎盘前置组为(1184±821)min,明显低于对照组的(1813±1121)min(χ2=7.333,t=4.032,t=2.088,P<0.05),其他指标两组比较无明显差异(P>0.05)。结论对胎盘前置妊娠妇女引产术前采用子宫动脉栓塞治疗具有较高的安全性,成功率较高。
Objective To investigate the clinical effect and safety of uterine arterial embolization before prenatal induction of labor in pre-pregnant women with placenta, and provide a reference method for safe labor induction in pre-pregnant women with placenta. Methods A retrospective analysis of 20 pregnant women (placenta previa group) requiring termination of pregnancy in the second trimester of placenta previa and 20 pregnant women (control group) without prenatal placenta during the same period were retrospectively analyzed. The placenta previa group was treated with uterine arterial embolization. No contractions occurred 12 hours after operation. 100 mg of ethacridine was injected into the amniotic cavity in the control group, and the time of labor, labor, blood loss, induced labor Before and after the blood, lochia duration, menstruation recovery time, uterine involution and the incidence of related complications. Results In the successful induction of labor, average labor duration, induced labor time, intraoperative blood loss, hemoglobin (Hb) difference, postoperative fever, postoperative lower extremity and lumbar pain, urinary retention, hematokrit (HCT) (P <0.05), there were significant differences among the 12 indexes of average value, average length of hospital stay, duration of lochia, and recovery time of menstruation (P <0.05). There was a significant difference in mean labor duration, induced labor duration and postoperative fever between placenta previa group and control group The preterm group was fever (10 cases) and the average labor duration was (589 ± 321) min, which was significantly higher than that of the control group (2 cases, 268 ± 161 minutes) and the preterm placenta previa group was (1184 ± 821) min, (1813 ± 1121) min (χ2 = 7.333, t = 4.032, t = 2.088, P <0.05) in the control group. There was no significant difference in the other indexes between the two groups (P> 0.05). Conclusion Pre-pregnant women with placenta prenatal induction of labor using uterine artery embolization has a higher safety, a higher success rate.