[1]左坤,王芳,陈德,等.中孕期瘢痕子宫胎盘前置并胎盘穿透性植入12例临床分析[J].中国计划生育和妇产科,2019,(5):36-41.
　ZUO Kun,WANG Fang,CHEN De,et al.Clinical analysis of 12 cases of scar uterus,placenta previa and placenta penetrating implantation in the second trimester[J].Chinese Journal of Family Planning & Gynecotokology,2019,(5):36-41.
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中孕期瘢痕子宫胎盘前置并胎盘穿透性植入12例临床分析
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2019年5期
页码:
36-41
栏目:
论著与临床
出版日期:
2019-05-25

文章信息/Info

Title:
Clinical analysis of 12 cases of scar uterus,placenta previa and placenta penetrating implantation in the second trimester
作者:
左坤1; 2; 王芳2; 陈德2; 王梅2; 赵有红2; 刘晓丽2; 蒲巍林2; 刘青1; 2*
1. 730000甘肃兰州，甘肃中医药大学；2. 730050甘肃兰州，甘肃省妇幼保健院孕产妇急救中心
Author(s):
ZUO Kun1; 2; WANG Fang2; CHEN De2; WANG Mei2; ZHAO You-hong2; LIU Xiao-li2; PU Wei-lin2; LIU Qing1; 2*
1.Gansu University of Chinese Medicine, Lanzhou Gansu 730000,P.R.China;2.Department of Maternal Emergency Centre，Gansu Provincial Maternal and Child Health Hospital,Lanzhou Gansu 730000,P.R.China
关键词:
瘢痕子宫、胎盘前置状态、胎盘植入、子宫下段部分切除、子宫动脉栓塞术
Keywords:
scar uterus;  placental preposition;  placenta implantation;  partial uterine resection;  uterine artery embolization
分类号:
R 719.8
摘要:
目的探讨中孕期瘢痕子宫胎盘前置状态并胎盘穿透性植入子宫下段部分切除术的临床应用价值。方法回顾性分析甘肃省妇幼保健院2013年4月至2018年4月收治的因胎死宫内或胎儿畸形要求终止妊娠的12例中孕期瘢痕子宫胎盘前置状态并胎盘穿透性植入患者的临床资料和子宫下段部分切除术的治疗效果。结果12例患者均成功保留子宫，其中10例术前行介入双侧子宫动脉栓塞术（uterine artery embolization，UAE）及盆腔侧支动脉血管栓塞术，2例直接行子宫下段部分切除术，1例介入双侧 UAE 后行利凡诺引产胎盘未娩出，再次行胎盘植入组织及子宫下段部分切除术。术后3月复查B超子宫复旧良好，无发热、再次出血、子宫切口愈合不良等并发症发生。结论子宫下段部分切除术是中孕期瘢痕子宫胎盘前置状态并穿透性胎盘植入孕妇有效的治疗方式，预防性应用UAE可有效减少术中出血，提高手术成功率，降低子宫切除率。
Abstract:
ObjectiveExplore the clinical value of partial hysterectomy in pregnant women with placenta previa and penetrating placenta implantation during second trimester.MethodsA retrospective analysis of the clinical data that requiring termination of pregnancy because of fetal death intrauterine or fetal malformation in Gansu Provincial Maternal and Child Health Hospital from April 2013 to April 2018, and the effect of partial hysterectomy in patients with placenta previa and penetrating placenta implantation in 12 cases.ResultsIn the 12 patients, the uterus was successfully retained, of which 10 underwent bilateral uterine arterial embolization(UAE) and pelvic collateral artery embolization, 2 cases were directly underwent partial hysterectomy, 1 case underwent failure of placenta delivery after UAE and induction of labor with Ethacridine Lactate,the placenta implantation tissue and the partial hysterectomy were performed. 3 months after the operation, no subinvolution of uterus, no fever, no bleeding, no poor healing of uterine incision and other complications occurred.ConclusionPartial hysterectomy is an effective treatment for pregnant women with placenta previa and penetrating placenta implantation during second trimester, and prophylactic application of UAE can effectively reduce intraoperative bleeding, improve the success rate of surgery and reduce the rate of hysterectomy.

参考文献/References:

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备注/Memo

备注/Memo:
甘肃省自然科学基金（项目编号：1606RJZA169）
更新日期/Last Update: 2019-05-25