大剂量甲氨蝶呤子宫动脉灌注栓塞术治疗胎盘植入产后出血56例分析  

Anlysis of the Bilateral Uterine Artery Embolization Combined With Methotrexate in Large Dose for Treatment of 56Cases With Postpartum Hemorrhge of Placenta Accrete

作　　者：马壮[1] 蔡舒[1] 宁华丽[1] 金新安[1] 刘翔[1] 黄波涛[1] 

机构地区：[1]广东医学院附属东莞市厚街医院介入中心,广东东莞523945

出　　处：《中华妇幼临床医学杂志（电子版）》2013年第4期439-442,共4页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

摘　　要：目的探讨采用大剂量甲氨蝶呤(MTX)进行子宫动脉灌注栓塞术(UAE)治疗胎盘植入导致产后出血(PPH)的疗效及可行性。方法选择2003年4月至2012年7月因胎盘植入导致PPH,采用Seldinger技术行右股动脉穿剌,经导管进行大剂量MTX UAE治疗的56例患者为研究对象。其中,完全性胎盘植入患者为9例,部分性胎盘植入为47例。对治疗相关指标进行分析(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,征得受试对象本人的知情同意,并与之签署临床研究知情同意书)。结果 56例患者的平均手术时间为(40±5)min,UAE后平均止血时间为(10.0±4.2)min,均抢救成功并保留子宫,术后随访6个月均无明显UAE并发症发生。结论大剂量MTX UAE治疗胎盘植入所致PPH具有止血迅速、微创、患者恢复快及经济等优点,且能保留患者子宫及生育功能等。Objective To explore the efficacy and feasibility of uterine arterial infusion and embolization（UAE） via bilateral uterine arteries for treatment of postpartum hemorrhage（PPH） of placenta implants by methotrexate（MTX） in large dose. Methods From April 2003 to July 2012, using Seldinger technique,56 patients were treated for PPH via UAE by MTX in large dose individually. Among them, 9 cases were complete placenta implants and 47 cases were partial placenta implants. Informed consent was obtained from all participants. Results The average operating time was （40±5） rain in total cases. After UAE, the average hemostatic time was （10.0±4.2） min. Each patient was rescued and retained the uterus. In the following up of 6 months, there was no evident complications among all cases. Conclusions UAE via bilateral uterine arteries for the treatment of PPH of placenta implants by MTX in large dose features fast, microinvasive, economic, retaining the uterus and fertility.

关 键 词：甲氨蝶呤 胎盘植入 子宫动脉 子宫动脉灌注栓塞术 

分 类 号：R714.461[医药卫生—妇产科学]