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纸质出版:2014
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李岚,杨鹰.双侧子宫动脉栓塞术治疗晚期妊娠胎盘植入患者临床分析[J].陆军军医大学学报(原第三军医大学学报),2014,36(10):1098-1101.
Li Lan,Yang Ying.Clinical analysis of bilateral uterine artery embolization for placenta accreta[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(10):1098-1101.
目的 探讨胎盘植入患者行子宫动脉栓塞术的临床特点、疗效及并发症。 方法 回顾性分析2006年1月至2012年12月我科110例胎盘植入患者中的晚期妊娠患者80例[子宫动脉栓塞(uterine artery embolization,UAE)组40例,子宫切除组9例,保守治疗组12例,剔除病例19例
]
的临床结局、栓塞治疗有效率(如出血减少或停止、月经复潮或再次妊娠)和失败率(如2次栓塞、子宫切除或产妇死亡),并比较3组患者的出血量、输血量、住院时间、胎盘排出和月经复潮时间。 结果 3组的年龄、孕周、孕次差异均无统计学意义(
P
0.05)。经子宫动脉栓塞术后38例成功止血,有2例未能止血而行子宫切除术。栓塞术后未出现器官局部缺血坏死、神经损伤等严重并发症,发热、下腹痛为常见并发症。3组的出血和输血量、手术时间、住院时间的差异有统计学意义(
P
0.05)。对UAE组患者进行为期1年的随访,除9例失访病例,其余患者在随访时间内恢复正常月经,并有2例再次妊娠者。 结论 子宫动脉栓塞术治疗胎盘植入的术前准备时间与手术时间短,出血控制迅速且并发症少,保留患者子宫,提高其生活质量。
Objective To explore clinical features
complications and curative effects of uterine artery embolization (UAE) on patients with placenta accrete. Methods We reviewed and analyzed the clinical outcome
effective rate (such as bleeding reduction or stop
menses return and re-pregnancy)
and ineffective rate (such as additional embolization treatment
hysterectomy
and maternal death) of embolization treatment in the 80 late pregnancy cases from 110 placenta accreta cases (including 40 cases in UAE group
9 cases in hysterectomy group
12 cases in conservative t
reatment group
and 19 finally eliminated cases) hospitalized in Xinqiao hospital from January 2006 to December 2012. Results There was no statistical significance of age
gestational weeks
times of pregnancy among the 3 groups (
P
0.05). After UAE
bleeding in 38 cases were successfully arrested
but 2 cases failed. There were common complications such as fever and abdominal pain
but no organ ischemia or nerve damage. The differences of blood loss and blood transfusion
operation time
and hospitalization time among the three groups had statistical significance (
P
0.05). One year follow-up was performed for the patients in the UAE group. Except for 9 lost patients during follow-up
31 patients resumed normal menstruation and 2 of them were pregnant again. Conclusion UAE has the advantages of short time of pre-operative preparation and operation
rapid bleeding control and reduced complications
and avoid hysterectomy to improve life quality in these patients.
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