本文選題：胎盤(pán)　切入點(diǎn)：前置　出處：《中國(guó)介入影像與治療學(xué)》2017年06期

【摘要】：目的探討雙側(cè)子宮動(dòng)脈預(yù)留導(dǎo)管產(chǎn)后行子宮動(dòng)脈栓塞術(shù)在兇險(xiǎn)性前置胎盤(pán)伴胎盤(pán)植入剖宮產(chǎn)術(shù)中的應(yīng)用價(jià)值。方法回顧性分析16例接受剖宮產(chǎn)聯(lián)合雙側(cè)子宮動(dòng)脈預(yù)置導(dǎo)管栓塞治療的兇險(xiǎn)性前置胎盤(pán)伴胎盤(pán)植入產(chǎn)婦的資料。記錄術(shù)中出血量、輸血量、子宮切除情況、透視時(shí)間、輻射劑量、并發(fā)癥及新生兒情況。結(jié)果剖宮產(chǎn)聯(lián)合雙側(cè)子宮動(dòng)脈栓塞術(shù)的技術(shù)成功率為93.75%(15/16)。術(shù)中平均出血量(1 575.00±1 040.83)ml,平均輸血量為(3.44±2.34)U懸浮少白細(xì)胞紅細(xì)胞。胎兒娩出前平均透視時(shí)間(0.89±0.24)min,平均輻射劑量(7.17±2.12)mGy。1例新生兒出生后重度窒息,其余15名新生兒出生后5min Apgar評(píng)分為(9.38±0.89)分。1例產(chǎn)婦因術(shù)后因再次活動(dòng)性出血并發(fā)彌漫性血管內(nèi)凝血而行全子宮切除術(shù)。2例產(chǎn)婦術(shù)后感臀部疼痛。結(jié)論雙側(cè)子宮動(dòng)脈預(yù)留導(dǎo)管產(chǎn)后行子宮動(dòng)脈栓塞術(shù)可用于兇險(xiǎn)性前置胎盤(pán)伴胎盤(pán)植入的治療,有利于減少剖宮產(chǎn)術(shù)中出血及輸血量,降低子宮切除的風(fēng)險(xiǎn),且輻射劑量較低、術(shù)后并發(fā)癥較少。
[Abstract]:Objective to investigate the value of uterine artery embolization after delivery with bilateral uterine artery catheter in the caesarean section of severe placenta previa with placenta accreta.Methods the data of 16 cases of dangerous placenta previa with placenta accreta treated by caesarean section and embolization of bilateral uterine artery preposition catheter were analyzed retrospectively.Intraoperative blood loss, blood transfusion, hysterectomy, fluoroscopy time, radiation dose, complications and neonatal conditions were recorded.Results the technical success rate of cesarean section combined with bilateral uterine artery embolization was 93.75 / 16.The average blood loss during operation was 1 575.00 鹵1 040.83ml, and the average transfusion volume was 3.44 鹵2.34U suspended oligocyte.The mean fluoroscopy time before delivery was 0.89 鹵0.24 minutes, and the average radiation dose was 7.17 鹵2.12)mGy.1 in the newborn.The 5min Apgar score of the remaining 15 newborns after birth was 9.38 鹵0.89. 1 cases of puerpera suffered from hip pain after hysterectomy because of secondary active hemorrhage and diffuse intravascular coagulation.Conclusion uterine artery embolization after delivery with bilateral uterine artery reserved catheter can be used in the treatment of dangerous placenta previa with placenta accreta. It is helpful to reduce bleeding and blood transfusion during cesarean section, reduce the risk of hysterectomy, and the radiation dose is low.There were fewer postoperative complications.
【作者單位】： 蘇州大學(xué)附屬第一醫(yī)院介入科;
【分類(lèi)號(hào)】：R714.2

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