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目的观察选择性子宫动脉化疗栓塞治疗胎盘植入致产后大出血的疗效及安全性。方法胎盘植入致产后大出血患者12例,均行选择性子宫动脉灌注甲氨蝶呤+明胶海绵栓塞,观察治疗效果、手术并发症发生情况,术后随访3个月观察子宫及月经情况。结果患者均一次止血成功并保留子宫;术后1~4周人绒毛膜促性腺激素水平恢复正常;9例术后出现轻度下腹部疼痛,无严重不良反应发生;术后3个月复查B超显示子宫形态恢复正常;术后1a患者月经均恢复正常。结论选择性子宫动脉化疗栓塞治疗胎盘植入所引起的产后大出血疗效满意,不良反应轻。
Objective To observe the efficacy and safety of selective uterine artery chemoembolization in treating postpartum hemorrhage caused by placenta accreta. Methods Twelve cases of postpartum hemorrhage were induced by placenta accreta. All patients underwent selective uterine arterial infusion of methotrexate and gelatin sponge. The therapeutic effect and complications were observed. The uterus and menstruation were observed 3 months after operation. Results All patients were hemostatic successfully and retained the uterus. The levels of human chorionic gonadotropin returned to normal after 1 ~ 4 weeks postoperatively. Nine patients had mild lower abdominal pain and no serious adverse reactions occurred. After 3 months of operation, B Ultra showed uterine morphology returned to normal; postoperative patients with menstruation were normal after 1 h. Conclusions Selective uterine artery chemoembolization is effective in treating postpartum hemorrhage caused by placenta accreta. The adverse reactions are mild.