股动脉预置管动脉栓塞治疗前置胎盘合并胎盘植入患者的临.PDFVIP

临床与病理杂志 2015, 35(7) 1282 J Clin Path ol R e s doi: 10.3978/j.issn.2095-6959.2015.07.015 View this article at: /10.3978/j.issn.2095-6959.2015.07.015 股动脉预置管动脉栓塞治疗前置胎盘合并胎盘植入 患者的临床观察 戴建荣，侯顺玉，陶建英 (苏州市立医院，苏州市母子医疗保健中心妇产科，江苏 苏州 215004) [摘　要] 目的：本文旨在探讨股动脉预置管 (prophylactic femoral artery catheterization)治疗前置胎盘合并胎 盘植入的有效性，目的在于保留子宫，步骤包括股动脉插管、子宫下段剖宫产、子宫动脉或髂内 动脉栓塞后娩出胎盘，保留子宫。方法：22 例患者术前或术中诊断为前置胎盘合并胎盘植入，对 6 例前置胎盘合并胎盘部分植入的患者剖宫产前行股动脉置管，待新生儿娩出后，立即行动脉栓 塞，栓塞成功后，术中尽量剥除胎盘，对有部分残留病例术后辅以MTX 治疗。另 16例采用传统方 法，无效行子宫切除术，或直接行剖宫产子宫切除术。 结果：6例预置管动脉栓塞的患者皆栓塞成 功，保留子宫。而对照组 16例最后皆子宫切除，两组在失血量，输红细胞悬液量及输血浆量方面 差异有显著性，两组总的手术时间无差异，需入住ICU及术后住院天数差异无显著性。 结论：股 动脉预置管动脉栓塞为前置胎盘合并胎盘植入的患者保留子宫提供了一种新的选择，可明显提高 患者生存质量，减少孕产妇并发症及病死率。 [关键词] 前置胎盘胎盘植入；股动脉预置管；动脉栓塞 A clinical study on prophylactic pelvic artery catheterization and embolization in women with placenta previa accreta in late gestation DAI Jianrong, HOU Shunyu, TAO Jianying (Department of Obstetrics, Suzhou Maternal and Child’s Health Center, Suzhou Municipal Hospital, Suzhou Jiangsu 215004, China) Abstract Objective: The purpose of this study was to describe the use of a staged procedure that involved femoral artery catheterization, cesarean section delivery, uterine and placental embolization, and placenta removal as possible as we can for placenta previa accreta in order to prevent from hysterectomy. Methods: The current study includes 22 patients diagnosed as placenta previa accreta identified histologi