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目的探讨介入子宫动脉栓塞术在植入性凶险型前置胎盘中的临床应用价值。方法前瞻性分析2013年1月至2014年2月唐山市妇幼保健院植入性凶险型前置胎盘患者40例,其中剖宫产术中胎儿娩出后立即行子宫动脉栓塞术,然后处理胎盘的23例为观察组;术中仅按常规处理胎盘的17例为对照组,观察两组患者出血量和子宫切除率。结果观察组术中出血量和产后24小时总出血量分别为459.78±212.33和565.92±123.12mlmL,均显著少于对照组(P<0.01),病例观察组子宫切除率和输血率均显著低于对照组(4.34%,VS 23.5%、8.69%VS 82.3%,P<0.05)。结论在植入性凶险型前置胎盘剖宫产术中早期行介入双侧子宫动脉栓塞术可以显著减少产后出血率,降低子宫切除率。
Objective To investigate the clinical value of interventional uterine artery embolization in implantable precancerous placenta previa. Methods Forty cases of implanted placenta previa placenta of Tangshan MCH hospital were prospectively analyzed from January 2013 to February 2014. The patients underwent cesarean arterial embolization immediately after delivery of the fetus in cesarean section and then treated with placenta Twenty-three cases were treated as observation group. Only 17 cases of normal placenta were treated as control group. The bleeding volume and hysterectomy rate were observed in both groups. Results The intraoperative blood loss and total 24 hours postpartum blood loss in the observation group were 459.78 ± 212.33 and 565.92 ± 123.12 ml mL, both significantly less than those in the control group (P <0.01). The hysterectomy rate and blood transfusion rate in the observation group were significantly lower than those in the control group Control group (4.34%, VS 23.5%, 8.69% VS 82.3%, P <0.05). Conclusions Early interventional bilateral uterine artery embolization in invasive cesarean section with placenta previa placenta can significantly reduce the rate of postpartum hemorrhage and reduce the rate of hysterectomy.