剖宫产术前子宫动脉置管术中行栓塞术对防治凶险性前置胎盘产后出血的疗效评价

发布时间：2019-03-07 09:27

【摘要】：目的评价凶险性前置胎盘患者剖宫产术前子宫动脉置管术中行子宫动脉栓塞术对防治产后出血的疗效并评估其临床意义。方法回顾性分析我院2013年6月至2014年12月收治的30例凶险性前置胎盘合并胎盘植入患者剖宫产术前经股动脉子宫动脉置管,胎儿娩出后立即行子宫动脉栓塞术(术中栓塞组)与20例剖宫产术后行子宫动脉栓塞术(术后栓塞组)的病例资料,比较两种方法治疗产后出血的效果。结果术中栓塞组出现弥散性血管内凝血(diffuse intravascular coagulation,DIC)2例(占6.7%),术后栓塞组发生DIC 4例(占20.0%),2组比较差异有统计学意义(P0.05)。术中栓塞组平均出血量(2 500±800)m L,术后栓塞组平均出血量(5 000±500)m L,2组比较差异有统计学意义(P0.05)。术中栓塞组剖宫产所需时间(80~135 min,平均102 min)少于术后栓塞组(110~170 min,平均138 min,P0.05)。结论对于凶险性前置胎盘合并胎盘植入者,于剖宫产术前子宫动脉置管术中行子宫动脉栓塞术,可有效减少术中、术后出血量,缩短手术时间,是一种值得提倡的治疗方法。
[Abstract]:Objective To evaluate the effect of uterine artery embolization on the prevention and treatment of post-partum hemorrhage and to evaluate its clinical significance. Methods From June 2013 to December,2014,30 cases of high-risk pre-placental combined placenta with placenta preimplantation were retrospectively analyzed, and the femoral artery and uterine artery were inserted before the cesarean section. The effect of two methods on the treatment of post-partum hemorrhage was compared in the case of uterine artery embolization (intraoperative embolization group) and 20 cases of post-cesarean section uterine artery embolization (post-operative embolization group). Results There were 2 cases (6.7%) of disseminated intravascular coagulation (DIC),4 cases of DIC (20.0%) and 2 groups (P <0.05). The mean amount of blood loss (2,500-800) m L in the embolized group and the mean blood loss of the post-operative embolization group (500-500) m-L and the difference of the two groups were statistically significant (P0.05). The time required for cesarean section during the operation (80-135 min, mean 102 min) was less than that of the post-operative embolization group (110-170 min, mean 138 min, P0.05). Conclusion It is a kind of therapeutic method to be advocated in the procedure of uterine artery embolization before and after caesarean section, which can be used to reduce the amount of blood loss and shorten the operation time.
【作者单位】：第三军医大学新桥医院妇产科;
【分类号】：R719.8

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