子宫血管缝扎术及宫颈环状缝扎术联合双侧髂内动脉球囊阻断治疗PPP合并胎盘植入效果  

Effect of the uterine vascular ligation and cervical circular ligation combined with bilateral iliac artery balloon occlusion for treating patients with pernicious previa placenta and placenta accreta

作　　者：毕冬华[1] 周芳芳 刘宇[1] 赵孟军[1] 李国芸[1] BI Donghua;ZHOU Fangfang;LIU Yu;ZHAO Mengjun;LI Guoyun(Xinciang Central Hospital,Xinxiang,Henan Province,453099)

机构地区：[1]河南省新乡市中心医院,453099

出　　处：《中国计划生育学杂志》2024年第8期1856-1859,共4页Chinese Journal of Family Planning

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20191322)。

摘　　要：目的:探讨凶险性前置胎盘(PPP)合并胎盘植入治疗效果。方法:选取2019年3月-2023年5月本院就诊治疗的PPP合并胎盘植入患者56例临床资料,根据治疗方式不同分为两组,采用子宫血管缝扎术及宫颈环状缝扎术联合双侧髂内动脉球囊阻断治疗为观察组26例,采用单纯双侧髂内动脉球囊阻断治疗为对照组30例,分析两组相关指标。结果:治疗后两组甲胎蛋白及绒毛膜促性腺激素水平均较术前降低,且观察组(82.6±26.3 ng/ml、122.3±56.3 mIU/ml)低于对照组(113.0±41.1 ng/ml、649.5±86.5 mIU/ml),总并发症发生率观察组(3.8%)低于对照组(23.3%)(均P<0.05);两组新生儿Apgar评分(9.6±0.3分、9.3±0.6分)无差异(P>0.05)。观察组住院时间(6.6±1.2d)及住院费用(3.2±0.6)万元均低于对照组(7.9±1.5d)(4.3±1.0)万元(P<0.05)结论:采取子宫血管缝扎与宫颈环状缝扎术、双侧髂内动脉球囊阻断治疗PPP合并胎盘植入可效果更佳,且可降低术后并发症,术后恢复更快,对新生儿未产生不良影响。Objective:To explore the efficacy of the uterine vascular ligation and cervical circular ligation combined with bilateral iliac artery balloon occlusion for treating patients with pernicious previa placenta(PPP)and placenta accreta.Methods:The clinical data of 56 patients with PPP and placenta accreta from March 2019 to May 2023 were selected in this study.According to the different treatment methods,these patients were divided into two groups,including 26 patients with the treatment of uterine artery ligation and cervical cerclage combined with bilateral internal iliac artery balloon occlusion in study group and 30 patients with the treatment of simple bilateral internal iliac artery balloon occlusion control in the control group.The relevant indicators of the patients in the two groups were analyzed.Results:The hospitalization time(6.6±1.2d)and the hospitalization cost(32000±6000 Yuan)of the patients in the study group were significantly lower than those(7.9±1.5d and 43000±10000 Yuan)of the patients in the control group.The levels of alpha-fetoprotein and chorionic gonadotropin of the patients in the two groups after treatment had decreased significantly,and which(82.6±26.3 ng/ml and 122.3±56.3 mIU/ml)of the patients in the study group were significantly lower than those(113.0±41.1 ng/ml and 649.5±86.5 mIU/ml)of the patients in the control group.The total complications rate(3.8%)of the patients in the study group was significantly lower than that(23.3%)of the patients in the control group(P<0.05).There was no significant difference in the neonatal Apgar score(9.6±0.3 points vs.9.3±0.6points)of the patients between the two groups(P>0.05).Conclusion:The efficacy of the uterine vascular ligation and cervical circular ligation combined with bilateral iliac artery balloon occlusion for treating the patients with PPP and placenta accreta has better effect,and which can reduce their postoperative complications and improve their postoperative recover,and without the adverse effect on their newborns.

关 键 词：凶险性前置胎盘合并胎盘植入 子宫血管缝扎术 宫颈环状缝扎术 双侧髂内动脉球囊阻断 治疗效果 并发症 新生儿 

分 类 号：R713.8[医药卫生—妇产科学]