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目的探讨子宫动脉栓塞术联合米非司酮及依沙吖啶(利凡诺)羊膜腔注射用于治疗中孕期中央型前置胎盘(胎盘前置状态)大出血的可行性及疗效。方法选取本院于2009年1月至2013年1月收治中孕期中央型前置胎盘(胎盘前置状态)大出血继发失血性贫血、胎儿宫内窘迫及死胎患者10例,采用回顾性分析方法,对患者临床资料、子宫动脉栓塞手术方法及治疗效果进行分析。结果 10例患者均顺利完成手术。在出血量方面,8例患者产后出血量均低于150ml,2例患者出血量为250~300ml。手术后患者心率较治疗前显著下降、血压、血红蛋白较治疗前均显著上升(P<0.05),且逐渐恢复到正常水平并趋于平稳。结论在对中孕期中央型前置胎盘(胎盘前置状态)大出血患者继发失血性贫血、胎儿宫内窘迫及死胎进行治疗时,子宫动脉栓塞术可有效缓解患者临床症状,大大减少出血量,并可有效改善患者各项基本生命体征,值得在临床中推广。
Objective To investigate the feasibility and efficacy of uterine artery embolization combined with mifepristone and ethacridine (rivanol) amniotic injection for the treatment of massive bleeding in the middle placenta previa (middle placenta previa) in the second trimester. Methods From January 2009 to January 2013, 10 cases of hemorrhagic anemia secondary to hemorrhagic anemia, fetal distress and stillbirth with central placenta previa (placenta previa) were selected from January 2009 to January 2013 in our hospital. Retrospective analysis , The clinical data of patients, uterine artery embolization method and treatment effect analysis. Results All the 10 patients successfully completed the operation. In the amount of bleeding, 8 patients were less than postpartum hemorrhage volume 150ml, 2 patients with bleeding amount of 250 ~ 300ml. After operation, the heart rate of patients was significantly lower than that before treatment. The blood pressure and hemoglobin increased significantly (P <0.05) before treatment, and gradually recovered to the normal level and stabilized. Conclusions Uterine artery embolization can effectively relieve the clinical symptoms of patients with secondary hemorrhagic anemia, fetal distress and stillbirth in patients with massive central placenta previa (pre-placenta previa) in the second trimester, significantly reducing the amount of bleeding, And can effectively improve the basic vital signs of patients, it is worth to promote in the clinic.