子宫动脉栓塞术介入治疗在中期妊娠胎盘前置状态引产中的应用  

Use of Uterine Artery Embolization in Induced Labor for Midtrimester Pregnant Women with Placenta Previa

作　　者：杨琳[1] 王星星[1] 李琴芬[1] 

机构地区：[1]贵阳医学院附属医院妇产科,贵州省贵阳市550004

出　　处：《中国全科医学》2013年第24期2874-2875,共2页Chinese General Practice

摘　　要：目的探索子宫动脉栓塞术介入治疗在中期妊娠胎盘前置状态引产中的应用。方法收集2010年6月—2013年3月在贵阳医学院附属医院妇产科住院治疗的中期妊娠胎盘前置状态引产的患者38例,行双侧子宫动脉栓塞治疗,术后4 h内行羊膜腔穿刺依沙吖啶注射引产。结果 38例行双侧子宫动脉栓塞术时间为20～50 min,平均30min。术后胎儿娩出时间为2～88 h,平均32 h;子宫动脉栓塞术后至分娩后24 h阴道流血量为50～200 ml,平均80ml;双侧子宫动脉栓塞术后3～7 d出院;7～20 d后血净,平均7 d。29例患者术后出现不同程度的下腹疼痛及腰部不适,3～20 d后自行缓解,平均7 d。术后9例患者出现体温升高,达37.5～38.5℃,考虑为栓塞术后反应,未予特殊处理体温降至正常。所有患者1周内子宫收缩至盆腔。术后随访患者无明显经量、经期及月经周期变化,也无潮热、盗汗、心烦等现象。结论子宫动脉栓塞术是避免中期妊娠胎盘前置状态引产过程中严重出血的安全方法,并有促进引产的作用。Objective To evaluate the efficacy and safety of uterine arterial embolization in induced labor for mid - tri- mester pregnant women with placenta previa. Methods A total of 38 pregnant women in their mid - trimester with placenta pre- via requiring termination of pregnancy in our department between June 2010 and March 2013 underwent the uterine bi - artery em- bolization and 4 hours later, aminocentesis and induction of labor with ethacridine. Results The time of uterine bi - artery em- bolization was 20 ~ 50 min with an average time of 30 min. The fetus was delivered 2 ~ 88 h after the procedure with an average of 32 h. The amount of vaginal bleeding from completion of the procedure to 24 h after delivery was 50 - 200 ml with an average amount of 80 ml. All subjects left hospital at day 3 - 7 after delivery. The bleeding stopped at day 7 - 20 after the delivery with an average of 7 days. Twenty - nine subjects had different degrees of lower abdominal pain and lower back discomfort, which alle- viated at day 3 - 20 with an average of 7 days. Nine subjects had temperature rise （ 37.5 - 38.5℃ ） which was seen as post - embolization reaction and returned to normal range without special treatment. The uterus contracted and returned to the pelvis within one week in all subjects. No significant changes were observed in menstrual volumn, length of period, and menstrual cy- cle; nor were tidal fever, night sweat, or disturbance observed. Conclusion Pre - operative uterine arterial embolization is a safe approach to prevent or reduce potential intra - operative bleeding in the induction of labor for pregnant women in their mid - trimester with placenta previa.

关 键 词：前置胎盘 引产 子宫动脉栓塞术 

分 类 号：R714.56[医药卫生—妇产科学]