王晓钦 傅秀华

[摘要]目的 探讨子宫动脉栓塞术（UAE）应用于胎盘植入的临床价值。方法 选取2015年1月～2017年12月我院84例胎盘植入患者作为研究对象，采用随机分组法分为两组，每组各42例。对照组使用常规治疗，观察组给与UAE，两组均予以清宫术。观察胎盘彻底清除时间、止血时间、术中失血量、子宫保留、胎盘排出概率、人绒毛膜促性腺激素（HCG）恢复时间、不良事件发生率。结果 观察组的胎盘彻底清除时间[（6.98±0.43）d]、止血时间[（17.33±2.92）d]均短于对照组[（10.45±1.98）d、（25.49±5.06）d]，术中失血量少于对照组[（823.49±7.71）ml]，观察组的子宫保留率（100.00%）及胎盘排出率（92.86%）均高于对照组（80.90%、73.81%），差异均有统计学意义（P<0.05）。观察组的HCG恢复时间[（6.77±1.43）d]短于对照组，不良事件发生率（2.38%）低于对照组（14.29%），差异有统计学意义（P<0.05）。结论 在胎盘植入治疗中，UAE应用价值较高，可有效排出胎盘、保护子宫，且预后效果较佳，安全性更高。

[关键词]子宫动脉栓塞术；胎盘植入；手术情况

[中图分类号] R714.462 [文献标识码] A [文章编号] 1674-4721（2018）9（a）-0109-03

[Abstract] Objective To investigate the clinical value of uterine arterial embolization （UAE） in placental implantation. Methods From January 2015 to December 2017， 84 patients with placenta accreta in our hospital were selected as research subjects. They were equally divided into two groups in random，42 cases in each group. In control group， conventional therapy was used， while in observation group， UAE was adopted. Both groups were treated with complete curettage of uterine cavity. The placenta thoroughly cleared time， blood stanching time， intraoperative blood loss， uterine retention， placental discharge probability， human chorionic gonadotropin （HCG） recovery time， and incidence of adverse events were observed in the two grops. Results In the observation group， the time of total placental clearance and blood stanching were （6.98±0.43） d and （17.33±2.92） d， both shorter than in the control group （[10.45±1.98]， [25.49±5.06] days）. The blood loss in the observation group was （823.49±7.71） ml， lesser than that in the control group. The uterine retention rate and placental discharge rate were 100.00% and 92.86% in the observation group， higher than those in the control group， accounting for 80.90% and 73.81%， which were displayed statistical significance （P<0.05）. The recovery time of HCG in the observation group was （6.77±1.43） d， shorter than that of the control group. The incidence of adverse events was 2.38%， lower than that of the control group accounting for 14.29% with a significant difference （P<0.05）. Conclusion UAE is of high value in the treatment of placenta accrete， which can effectively excrete the placenta and protect the uterus. The prognosis is favorable and the safety is high.

[Key words] Uterine arterial embolization； Placenta implantation； Operative situation

胎盤植入作为产科常见疾病，危害性较大，可能会导致休克、脏器损伤、大出血以及感染等意外事件发生，对患者身体健康及生命安全造成严重威胁。以往多使用药物治疗，可取得一定效果[1]，但并不理想，部分患者甚至要切除子宫，虽然能挽救生命，但子宫的切除给患者带来沉重的生理及心理负担，不良应激则会进一步阻碍病情康复，影响预后效果。随着医疗技术的不断发展，放射介入手术以其操作时间短、创伤小、预后佳等优势，广泛应用于疾病治疗中。本文旨在探讨子宫动脉栓塞术（UAE）应用于胎盘植入患者的效果，现报道如下。

1资料与方法

1.1一般资料

选取2015年1月～2017年12月我院收治的84例胎盘植入患者作为研究对象，按随机分组法均分为对照组和观察组，每组各42例。……