子宫动脉栓塞术在孕20周前瘢痕子宫合并胎盘前置状态患者引产的疗效及其对近期卵巢功能的影响  

Effect of uterine artery embolization on termination of pregnancy in patients with uterus scar and placenta previa before 20 weeks and its effect on short-term ovarian function

作　　者：桂甜甜 马洋妮 赵秉莳 杨伟[1,2] GUI Tiantian;MA Yangni;ZHAO Bingshi;YANG Wei(Department of Obstetrics and Gynecology,People's Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China;The First Affiliated Hospital of Northwest Minzu University,Yinchuan 750002,China)

机构地区：[1]宁夏回族自治区人民医院妇产科,宁夏银川750002 [2]西北民族大学第一附属医院,宁夏银川750002

出　　处：《宁夏医学杂志》2021年第11期992-995,共4页Ningxia Medical Journal

摘　　要：目的探讨瘢痕子宫合并胎盘前置状态患者在孕20周前引产时行子宫动脉栓塞术(UAE)的疗效及其对近期卵巢功能的影响。方法回顾性分析孕20周前瘢痕子宫合并胎盘前置状态要求引产的70例孕妇临床资料,其中行UAE+钳刮术的40例为实验组,行钳刮术的30例为对照组。对比2组患者年龄、孕次、产次、孕周、既往剖宫产次数、住院时间、住院费用;本次妊娠距前次剖宫产时间、胎盘附着部位、胎盘类型;钳刮手术相关指标:术中出血量、术中及术后输注同型红细胞悬液量及血浆量、手术时间、术中联合宫腔球囊填塞例数、术后相关并发症例数;引产后指标:引产后月经恢复后经期、经量及月经周期,月经恢复后第3次月经周期促卵泡激素(FSH)、促黄体生成激素(LH)、雌二醇(E_(2))水平。结果实验组患者和对照组相比住院时间更短(P<0.05)。实验组患者本次妊娠距前次剖宫产时间更短、胎盘附着于子宫前壁下段例数更多、完全性前置胎盘例数更多(P<0.05)。实验组患者钳刮术中出血量及输血量更少、手术时间更短、术后并发症更少(P<0.05)。结论选择刮宫术联合UAE不仅可有效减少引产过程中出血量,降低输血量及输血风险,减少了术中及术后并发症,缩短了钳刮手术时间及住院时间,但不影响患者月经恢复及短期卵巢储备功能。Objective To investigate the efficacy of Uterine Artery Embolization(UAE)and its effect on ovarian function in patients with uterus scar and placenta previa decided termination before 20 weeks of pregnancy.Methods Retrospective analysis 70 cases which diagnosed as“uterus scar and placenta previa decided termination before 20 weeks of pregnancy”.Among them,40 patients with the operation of“UAE+curettage”were in the experimental group,and 30 patients with the operation of“curettage”were in the control group.Age,times of pregnancy,times of labor,gestational weeks,times of previous cesarean section,length of hospital stays,the total cost of hospitalization were compared;the time from pregnancy to the previous cesarean section,the placenta is attached to the anterior or posterior wall of the uterus,the type of placenta were compared between two groups.The total blood loss,transfusion of red blood cell,transfusion of plasma,operation time,the number of those combined with intrauterine balloon tamponade cases,and complications were recorded.The menstrual period,menstrual volume and menstrual cycle after menstruation recovery,serum Follicle Stimulating Hormone(FSH),Luteinizing Hormone(LH)and estradiol(E_(2))levels in the third menstrual cycle after menstruation recovery were recorded in all patients.Results The length of hospital stay in the experimental group was shorter than that in the control group;The hospitalization expenses of the experimental group were higher than those of the control group,and both results were statistically significant(P<0.05).The time since the last cesarean section in the experimental group was shorter than that in the control group.Compared with the control group,there were more cases of placenta attached to the lower part of the anterior wall of the uterus in the experimental group,and most of the placental types belonged to complete placenta previa,with the statistical difference(P<0.05).The total amount of bleeding,the amount of red blood cell infusion,the amount of plasma in

关 键 词：胎盘前置状态 瘢痕子宫 中期引产 子宫动脉栓塞术 卵巢功能 

分 类 号：R619[医药卫生—外科学]