胎盘植入行经子宫动脉氨甲喋呤灌注、栓塞联合宫腔镜下清宫术的临床分析  

Clinical analysis of methotrexate perfusion,embolization via uterine artery combined hysteroscopic curettage in patients with placenta implantation

作　　者：陈丽[1] 樊晓君[1] 王莉[1] 

机构地区：[1]宝鸡市妇幼保健院妇产科,陕西宝鸡721001

出　　处：《中国计划生育和妇产科》2016年第1期45-48,共4页Chinese Journal of Family Planning & Gynecotokology

基　　金：陕西省卫生科研项目(项目编号:2014-D27)

摘　　要：目的探讨胎盘植入行经子宫动脉氨甲喋呤(Methotrexate,MTX)灌注、栓塞联合宫腔镜下清宫术的临床效果。方法回顾性分析2013年1月至2014年1月宝鸡市妇幼保健院妇产科收治的40例胎盘植入患者的临床资料,按照不同治疗方法分为对照组和观察组,每组20例。对照组给予常规清宫;观察组经子宫动脉MTX灌注、栓塞联合宫腔镜下清宫。比较两组患者的出血情况、住院天数以及子宫切除率。结果观察组患者的术中出血量(225±21)m L和术后2 h出血量(94±16)m L及总出血量(404±41)m L均显著少于对照组[(930±162)m L、(470±102)m L、(1712±131)m L],住院天数(4.1±0.4)d显著短于对照组(6.3±0.7)d,子宫切除率为0,显著低于对照组(20.0%),两组比较差异均有统计学意义(P<0.05)。结论对胎盘植入患者实施经子宫动脉MTX灌注、栓塞联合宫腔镜下清宫术可以取得良好的治疗效果。Objective To explore the clinical effect of methotrexate （MTX） perfusion, embolization via uterine artery combined hysteroscopic curettage in patients with placenta implantation. Methods Clinical data of 40 patients with placenta accreta from January 2013 to January 2014 in Maternal and Child Health Hospital of Baoji City were retrospectively analyzed. The patients were divided into control group （n = 20） and observation group （n = 20） according to therapeutic methods. Patients in control group were treated with conventional curettage, and the observation group treated with MTX perfusion cmbolization via uterine artery combined with hysteroscopy curettage. Bleeding, hospitalization and uterus resection rate between the two groups were compared. Results The intraoperative blood loss, postoperative 2 hours bleeding amount and the total amount of bleeding in observation group were significantly less than those of the control group. The hospital span in observation group was significantly shorter than that of the control group, and the uterus resection rate was 0 in observation group, significantly lower than that of the control group （20. 0 % ）, the difference was statistically significant（P 〈 0. 05 ）. Conclusion Uterine artery MTX infusion and embolization combined with uterine curettage under hysteroscopy had good therapeutic effect on the patients with placenta acereta.

关 键 词：胎盘植入 清宫术 子宫动脉栓塞 宫腔镜 氨甲喋呤 

分 类 号：R713.41[医药卫生—妇产科学]