分娩前后行子宫动脉介入栓塞术治疗凶险型前置胎盘剖宫产的效果对比  

Comparison of the efficacy of uterine artery intervention embolization before and after delivery in the treatment of dangerous placenta previa during cesarean section

作　　者：汪俊红[1] 陈莹[1] 刘丹[1] 李艳 WANG Jun-hong;CHEN Ying;LIU Dan(Department of Obstetrics,Tangshan Maternal and Child Health Hospital,Tangshan Hebei 063000,China)

机构地区：[1]唐山市妇幼保健院产科,河北唐山063000

出　　处：《临床和实验医学杂志》2024年第1期77-80,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省2020年度医学科学研究课题计划(编号:20201488)。

摘　　要：目的探究分娩前后行子宫动脉介入栓塞术治疗凶险型前置胎盘剖宫产的效果。方法回顾性选取2020年10月至2021年10月唐山市妇幼保健院收治的108例凶险型胎盘前置患者为研究对象,按照患者采取的治疗手段不同分为观察组(n=58)和对照组(n=50)。观察组给予分娩前子宫动脉介入栓塞术,对照组给予分娩后子宫动脉介入栓塞术。对比两组的手术出血相关指标(术中、术后出血量、术中输红细胞量、术中输血浆量)、术后康复指标(手术时间、住院时间、恶露延续时间、月经恢复时间)、肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)及成纤维细胞生长因子-23(FGF-23)水平;并比较两组栓塞成功率、弥漫性血管内凝血(DIC)发生率、子宫摘除率、术后不良反应发生率情况。结果观察组术中、术后出血量、术中输红细胞量、术中输血浆量分别为(1398.29±819.29)、(298.94±98.84)、(993.18±206.95)、(521.94±109.24)mL,均少于对照组[(2109.49±798.26)、(505.28±94.92)、(1604.68±311.95)、(998.29±115.39)mL],差异均有统计学意义(P<0.05)。观察组患者手术时间和住院时间分别为(69.29±11.33)min、(6.98±1.93)d,均短于对照组[(89.09±10.82)min、(12.49±1.68)d],差异均有统计学意义(P<0.05)。手术后,观察组TNF-α、IL-6、FGF-23水平分别为(14.09±2.88)ng/L、(8.13±3.78)ng/L、(43.92±9.84)pg/mL,均显著低于对照组[(19.94±2.75)ng/L、(14.79±3.09)ng/L、(54.13±9.98)pg/mL],差异均有统计学意义(P<0.05)。观察组栓塞成功率为98.27%,高于对照组(76.00%),差异有统计学意义(P<0.05)。观察组DIC发生率、子宫摘除率、术后感染、失血性休克、子宫收缩异常、胎儿生命体征异常等不良反应发生率分别为5.17%、0、1.72%、0、3.44%、1.72%,均低于对照组(38.00%、4.00%、8.00%、38.00%、18.00%、16.00%),差异均有统计学意义(P<0.05)。结论分娩前给予凶险型前置胎盘患者行子宫动脉介入栓塞术,可�Objective To investigate the efficacy of uterine artery intervention embolization before and after delivery in the treatment of dangerous placenta previa cesarean section.Methods A total of 108 patients with dangerous placenta previa admitted to Tangshan Maternal and Child Health Hospital from October 2020 to October 2021 were retrospectively selected as the research objects.According to the treatment methods adopted by the patients,they were divided into the observation group(n=58)and the control group(n=50).The observation group received interventional uterine artery embolization before delivery,and the control group received uterine artery interventional embolization after delivery.The surgical bleeding related indicators(intraoperative and postoperative blood loss,intraoperative red blood cell transfusion volume,intraoperative plasma transfusion volume)and postoperative rehabilitation indicators(operation time,hospital stay,lochia duration,menstrual recovery time),the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and fibroblast growth factor-23(FGF-23)after operation were compared between the two groups.The embolization success rate,disseminated intravascular coagulation(DIC)incidence rate,hysterectomy rate and other adverse reactions were compared between the two groups.Results Intraoperative and postoperative blood loss,intraoperative red blood cell transfusion and intraoperative plasma transfusion in the observation group were(1398.29±819.29),(298.94±98.84),(993.18±206.95),(521.94±109.24)mL,respectively,which were lower than those in the control group[(2109.49±798.26),(505.28±94.92),(1604.68±311.95),(998.29±115.39)]mL,and the differences were statistically significant(P<0.05).The operation time and hospital stay in the observation group were(69.29±11.33)min,(6.98±1.93)d,which were shorter than those in the control group[(89.09±10.82)min,(12.49±1.68)d],and the differences were statistically significant(P<0.05).After operation,the levels of TNF-α,IL-6,FGF-23 in the observation gr

关 键 词：子宫动脉介入栓塞术 凶险型前置胎盘 弥漫性血管内凝血 栓塞成功率 

分 类 号：R719.8[医药卫生—妇产科学]