项金晶 朱瑞珍

【摘要】 目的：觀察预防性子宫动脉栓塞术在前置胎盘孕妇妊娠中晚期引产中的临床效果。方法：纳入笔者所在医院2018年2月-2019年10月治疗的妊娠中晚期前置胎盘引产68例孕妇，采用随机数字表法将其分为观察组和对照组，各34例。对照组采用常规引产，观察组行预防性子宫动脉栓塞术后引产，比较两组引产中出血量、产后24 h出血量、总产程、住院时间、恶露持续时间、月经恢复时间及并发症发生情况。结果：观察组引产中出血量及产后24 h出血量均显著少于对照组，差异有统计学意义（P<0.05）。观察组总产程（350.36±32.18）min、住院时间（5.48±1.21）d、恶露持续时间（12.33±3.20）d、月经恢复时间（34.37±3.95）d，均显著优于对照组，差异有统计学意义（P<0.05）。观察组并发症发生率为5.88%，低于对照组的23.53%，差异有统计学意义（P<0.05）。结论：前置胎盘孕妇妊娠中晚期引产前行预防性子宫动脉栓塞术，可明显降低引产中及产后出血量及并发症发生率。

【关键词】 前置胎盘 预防性子宫动脉栓塞术 中晚期引产

doi：10.14033/j.cnki.cfmr.2020.13.051 文献标识码 B 文章编号 1674-6805（2020）13-0-03

Effect of Prophylactic Uterine Artery Embolization in the Induction of Labor in the Middle and Late Pregnancy of Placenta Previa Pregnant Women/XIANG Jinjing， ZHU Ruizhen. //Chinese and Foreign Medical Research， 2020， 18（13）： -127

[Abstract] Objective： To observe the clinical effect of prophylactic uterine artery embolization in the induction of labor in the middle and late pregnancy of placenta previa pregnant women. Method： A total of 68 pregnant women in middle and late pregnancy of placenta previa who were treated in our hospital from February 2018 to October 2019 were included. They were divided into the observation group and the control group by random number table method， 34 cases in each group. The control group received routine induction of labor. The observation group received induction of labor after prophylactic uterine artery embolization. The amount of bleeding during labor induction， postpartum amount of bleeding at 24 h， total labor process， hospitalization time， duration of lochia， menstrual recovery time and complications were compared between the two groups. Result： The amount of bleeding during labor induction and postpartum amount of bleeding at 24 h in the observation group were significantly less than those in the control group， the differences were statistically significant （P<0.05）. The total labor process （350.36±32.18） min， hospitalization time （5.48±1.21） d， duration of lochia （12.33±3.20） d and menstrual recovery time （34.37±3.95） d in the observation group were significantly better than those in the control group， the differences were statistically significant （P<0.05）. The incidence of complications in the observation group was 5.88%， which was lower than 23.53% in the control group， the difference was statistically significant （P<0.05）. Conclusion： Prophylactic uterine artery embolization before induction of labor in the middle and late pregnancy of placenta previa pregnant women can significantly reduce the amount of bleeding during labor induction and postpartum and the incidence of complications.

[Key words] Placenta previa Prophylactic uterine artery embolization Middle and late induction of labor

First-authors address： Yangjiang Peoples Hospital， Yangjiang 529500， China

前置胎盘是指在妊娠28周后胎盘没有正常附着于宫体部的后壁、前壁或者侧壁，而是附着于子宫下段，或覆盖宫颈内口。前置胎盘的发生率为0.18%～1.18%，在经产妇中发病率较高，其典型症状是晚期反复的无痛性阴道出血[1-2]。前置胎盘是妊娠中晚期引产的高危因素，易引起引产后大出血，甚至会对孕产妇的生命造成威胁[3]。寻找安全、高效、低风险的前置胎盘孕妇引产的方法，尽可能保留孕产妇的生育能力，是妇产科医生较为关注的问题。近年来，随着介入放射学科的不断发展，子宫动脉栓塞术成为引产后控制大出血的有力措施[4-5]。本研究对笔者所在医院纳入的妊娠中晚期前置胎盘引产的孕妇采用预防性子宫动脉栓塞术，极大降低了孕妇的引产风险，现将研究结果报道如下。

1 资料与方法