子宫动脉栓塞术对穿透性凶险性前置胎盘患者凝血系统及母婴结局的影响  

Effect of uterine artery embolization on the coagulation system and maternal and infant outcome of patients with penetrating dangerous placenta previa

作　　者：王慧[1] 毛俊文[1] 尹维[1] 张瑞[1] 宋科鹰 华瑞佳 廖海君 Wang Hui;Mao Junwen;Yin Wei;Zhang Rui;Song Keying;Hua Ruijia;Liao Haijun(Department of Obstetrics,Mianyang People’s Hospital,Sichuan Province,Mianyang 643100,China)

机构地区：[1]四川省绵阳市人民医院产科,643100

出　　处：《疑难病杂志》2020年第10期1038-1041,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察子宫动脉栓塞术对穿透性凶险性前置胎盘患者凝血系统及母婴结局的影响。方法择取2015年3月—2017年9月绵阳市人民医院产科收治的穿透性凶险性前置胎盘患者90例作为研究对象,按照随机数字表法分为2组,各45例。观察组给予子宫动脉栓塞术治疗,对照组采用非子宫动脉栓塞术治疗。对比2组手术情况、手术前后凝血系统相关指标变化、并发症发生率及新生儿Apgar评分。结果观察组患者术中出血量、红细胞输血量及冷沉淀输血量均少于对照组,差异有统计学意义(t=11.848、3.994、5.739,P<0.01);2组血浆输血量、住院时间比较,差异无统计学意义(P>0.05);术后,观察组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)均高于对照组,D-二聚体(D-D)水平低于对照组,差异有统计学意义(t=7.102、3.023、4.438、9.544,P<0.01);观察组ICU入住率、产后出血、子宫切除率、弥散性血管内凝血(DIC)、失血性休克发生率均低于对照组,差异有统计学意义(χ^2=16.878、21.700、15.011、14.484、7.283,P<0.01);2组新生儿均未出现严重窒息,Apgar评分比较差异无统计学意义(Z=1.800,P>0.05)。结论穿透性凶险性前置胎盘患者行子宫动脉栓塞术可有效减少产后出血,且不会对凝血系统造成影响,利于减少母婴不良结局的发生。Objective To observe the effect of uterine artery embolization on the coagulation system and maternal and infant outcomes of patients with penetrating and dangerous placenta previa.Methods From March 2015 to September 2017,90 patients with penetrating and dangerous placenta previa admitted to the Obstetrics Department of Mianyang People's Hospital were selected as the research objects,and they were divided into 2 groups according to the random number table method,with 45 cases in each group.The observation group was treated with uterine artery embolization,and the control group was treated with non-uterine artery embolization.The operation status,changes of blood coagulation system-related indexes before and after operation,the incidence of complications and the Apgar score of newborns were compared between the two groups.Results The amount of intraoperative blood loss,red blood cell transfusion and cryoprecipitate blood transfusion of the observation group were less than those of the control group,and the difference was statistically significant(t=11.848,3.994,5.739,P<0.01);comparison of plasma blood transfusion and length of stay in the two groups,The difference was not statistically significant(P>0.05);after the operation,the activated partial thromboplastin time(APTT),prothrombin time(PT)and fibrinogen(FIB)of the observation group were higher than those of the control group,D dimeri(D-D)level was lower than the control group,the difference was statistically significant(t=7.102,3.023,4.438,9.544,P<0.01);the observation group ICU occupancy rate,postpartum hemorrhage,hysterectomy rate,diffuse intravascular coagulation(DIC)and the incidence of hemorrhagic shock were lower than those of the control group,and the difference was statistically significant(χ^2=16.878,21.700,15.011,14.484,7.283,P<0.01);there was no severe asphyxia in the two groups of neonates,Apgar score comparison The difference was not statistically significant(Z=1.800,P>0.05).Conclusion Uterine artery embolization in patients with penetrating dang

关 键 词：子宫动脉栓塞术 前置胎盘 凝血功能 母婴结局 

分 类 号：R714.4[医药卫生—妇产科学]