子宫动脉化疗栓塞术治疗完全性胎盘植入的效果  

Curative effect of uterine artery chemoembolization in treatment of complete placental implantation

作　　者：敬巧[1] 张娟[1] 范波[1] 

机构地区：[1]川北医学院附属医院妇产科,四川南充637000

出　　处：《中国妇幼保健》2018年第1期185-188,共4页Maternal and Child Health Care of China

基　　金：四川省教育厅自然科学重点项目(15ZA0198)

摘　　要：目的探讨子宫动脉化疗栓塞术治疗完全性胎盘植入的效果。方法选取2015年2月-2016年1月于川北医学院附属医院就诊的完全性胎盘植入患者124例,根据就诊顺序分为观察组和对照组,每组各62例。对照组患者采用甲氨蝶呤治疗,观察组患者采用子宫动脉化疗栓塞术治疗。比较两组患者治疗结局、治疗指标、治疗期间不良反应及随访1年结局。结果两组患者子宫保留率、自行排出率及清宫率比较差异均有统计学意义(均P<0.05)。两组患者清宫前阴道出血量、清宫术出血量、胎盘清除时间、血清β-人绒毛膜促性腺激素(β-hCG)水平恢复正常时间、甲氨蝶呤用量比较,差异均有统计学意义(均P<0.05)。两组患者治疗期间不良反应发生率比较,差异均有统计学意义(均P<0.05)。随访1年,两组患者月经异常发生率、再次妊娠率比较差异均无统计学意义(均P>0.05);两组患者宫颈粘连发生率比较差异有统计学意义(P<0.05)。结论子宫动脉化疗栓塞术治疗完全性胎盘植入效果显著,有利于及时控制产后出血,降低子宫切除率,确保孕产妇生命安全,临床价值较高,是一种可行的治疗途径。Objective To explore the curative effect of uterine artery chemoembolization in treatment of complete placental implantation. Methods A total of 124 patients with complete placental implantation treated in Affiliated Hospital of North Sichuan Medical College from February 2015 to January 2016 were selected and divided into observation group and control group according to the sequence of visiting the hospital,62 patients in each group. The patients in control group were treated by methotrexate,and the patients in observation group were treated by uterine artery chemoembolization. The treatment outcomes,parameters,adverse reactions,and follow-up outcomes at one year after treatment were compared between the two groups. Results There were statistically significant differences in the retention rate of uterus,rate of spontaneous excretion,and the rate of uterine curettage between the two groups（ all P0. 05）. There were statistically significant differences in the amount of vaginal bleeding before uterine curettage,the amount of intraoperative bleeding,the time of placental clearance,the time of serum β-human chorionic gonadotropin（ β-hCG） level return to normal,and the dose of methotrexate between the two groups（ all P0. 05）. There were statistically significant differences in the incidence rates of adverse reactions during the treatment between the two groups（ all P0. 05）. At one year after treatment,there was no statistically significant difference in the incidence rate of menoxenia and the rate of subsequent pregnancy between the two groups（ both P0. 05）. There was statistically significant difference in the incidence rate of intrauterine adhesion between the two groups（ P 0. 05）. Conclusion The curative effect of uterine artery chemoembolization in treatment of complete placental implantation is significant,uterine artery chemoembolization can timely control postpartum hemorrhage,reduce hysterectomy rate,and ensure the safety of pregnant women,the clinical value is high,which is a feasibl

关 键 词：完全性胎盘植入 子宫动脉化疗栓塞术 效果 

分 类 号：R713.4[医药卫生—妇产科学]