双侧子宫动脉预留导管栓塞在凶险性前置胎盘伴胎盘植入中的应用

发布时间：2018-04-03 02:28

本文选题：胎盘　切入点：前置　出处：《中国介入影像与治疗学》2017年06期

【摘要】：目的探讨双侧子宫动脉预留导管产后行子宫动脉栓塞术在凶险性前置胎盘伴胎盘植入剖宫产术中的应用价值。方法回顾性分析16例接受剖宫产联合双侧子宫动脉预置导管栓塞治疗的凶险性前置胎盘伴胎盘植入产妇的资料。记录术中出血量、输血量、子宫切除情况、透视时间、辐射剂量、并发症及新生儿情况。结果剖宫产联合双侧子宫动脉栓塞术的技术成功率为93.75%(15/16)。术中平均出血量(1 575.00±1 040.83)ml,平均输血量为(3.44±2.34)U悬浮少白细胞红细胞。胎儿娩出前平均透视时间(0.89±0.24)min,平均辐射剂量(7.17±2.12)mGy。1例新生儿出生后重度窒息,其余15名新生儿出生后5min Apgar评分为(9.38±0.89)分。1例产妇因术后因再次活动性出血并发弥漫性血管内凝血而行全子宫切除术。2例产妇术后感臀部疼痛。结论双侧子宫动脉预留导管产后行子宫动脉栓塞术可用于凶险性前置胎盘伴胎盘植入的治疗,有利于减少剖宫产术中出血及输血量,降低子宫切除的风险,且辐射剂量较低、术后并发症较少。
[Abstract]:Objective to investigate the value of uterine artery embolization after delivery with bilateral uterine artery catheter in the caesarean section of severe placenta previa with placenta accreta.Methods the data of 16 cases of dangerous placenta previa with placenta accreta treated by caesarean section and embolization of bilateral uterine artery preposition catheter were analyzed retrospectively.Intraoperative blood loss, blood transfusion, hysterectomy, fluoroscopy time, radiation dose, complications and neonatal conditions were recorded.Results the technical success rate of cesarean section combined with bilateral uterine artery embolization was 93.75 / 16.The average blood loss during operation was 1 575.00 卤1 040.83ml, and the average transfusion volume was 3.44 卤2.34U suspended oligocyte.The mean fluoroscopy time before delivery was 0.89 卤0.24 minutes, and the average radiation dose was 7.17 卤2.12)mGy.1 in the newborn.The 5min Apgar score of the remaining 15 newborns after birth was 9.38 卤0.89. 1 cases of puerpera suffered from hip pain after hysterectomy because of secondary active hemorrhage and diffuse intravascular coagulation.Conclusion uterine artery embolization after delivery with bilateral uterine artery reserved catheter can be used in the treatment of dangerous placenta previa with placenta accreta. It is helpful to reduce bleeding and blood transfusion during cesarean section, reduce the risk of hysterectomy, and the radiation dose is low.There were fewer postoperative complications.
【作者单位】：苏州大学附属第一医院介入科;
【分类号】：R714.2

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