预防性子宫动脉栓塞在产科疾病中的应用  

Clinical application of prophylactic uterine artery embolization in obstetrical diseases

作　　者：黄加胜[1] 张慕玲[2] 束晓明[2] 王海蓉[2] 王煊[1] 陈卫[1] 

机构地区：[1]南京医科大学附属淮安第一医院介入科,江苏淮安223300 [2]南京医科大学附属淮安第一医院产科,江苏淮安223300

出　　处：《介入放射学杂志》2013年第12期980-982,共3页Journal of Interventional Radiology

摘　　要：目的 探讨预防性子宫动脉栓塞在产科疾病中的应用价值.方法 收集2007年1月—2012年7月瘢痕妊娠、宫颈妊娠及前置胎盘患者共17例（栓塞组）,在流产、刮宫术前行预防性双侧子宫动脉栓塞术,并与前期或同期行清宫及药流等其他方案治疗的瘢痕妊娠、宫颈妊娠及前置胎盘共15例患者（非栓塞组）比较治疗出血量、并发症、保宫率差异.结果 栓塞组17例介入手术全部成功,刮宫术中出血少,平均20 ml,无严重并发症发生,随访40 ～ 150 d后月经恢复正常.非栓塞组患者中出血量较多的有4例,其中3例切除子宫,2例发生与手术相关并发症.栓塞组与非栓塞组术中出血、并发症的发生及保宫率差异有统计学意义（P＜ 0.01）.结论 预防性子宫动脉栓塞可减少瘢痕妊娠、宫颈妊娠及前置胎盘患者术中子宫出血、并发症发生,增加保宫率,是安全有效、疗效确切的治疗方法.Objective To investigate clinical application of prophylactic uterine artery embolization （UAE） in obstetrical diseases.Methods A total of 17 patients （embolization group） with cesarean scar pregnancy,cervical pregnancy or placenta previa,who were encountered at the hospital during the period from Jan.2007 to July 2012,were enrolled in the study.Prophylactic bilateral UAE was carried out before artificial abortion and curettage in all the 17 patients.Another 15 patients with cesarean scar pregnancy,cervical pregnancy or placenta previa,who had received curettage and medical abortion,were used as nonembolization group.The blood loss,complication and uterine reservation rate were recorded,and the results were compared between the two groups.Results Interventional procedure was successfully accomplished in all 17 patients of embolization group.The mean blood loss during curettage was only 20 ml,with no severe complications.During the follow-up period lasting 40-150 days the menstrual-cycle restored to normal.In non-embolization group,large amount of blood loss was seen in 4 cases,hysterectomy had to be carried out in 3 cases,and surgery-related complications occurred in 2 cases.Statistically significant differences in the volume of blood loss,occurrence of complications and uterine reservation rate existed between the two groups （P 〈 0.01）.Conclusion Prophylactic uterine artery embolization can reduce the amount of blood loss in uterine surgery,the incidence of complications and increase the uterine reservation rate in patients with cesarean scar pregnancy,cervical pregnancy or placenta previa.This technique is safe and effective with reliable results.

关 键 词：妊娠 子宫动脉栓塞术 瘢痕妊娠 宫颈妊娠 前置胎盘 

分 类 号：R714[医药卫生—妇产科学]