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目的分析中央型前置胎盘大出血采用米非司酮、米索前列醇终止妊娠联合子宫动脉栓塞术治疗的可行性和临床效果。方法选择治疗的中央型前置胎盘大出血患者共18例为研究对象,均采用口服米非司酮、米索前列醇阴道后穹窿放置终止妊娠,子宫动脉栓塞术治疗,收集18例患者的临床资料进行回顾性分析,评估可行性和临床治疗效果。结果入组病例手术进行顺利,无中转开腹病例,11例手术完成后阴道流血即刻停止,6例术后24h阴道流血量<150ml,1例术后24h阴道流血量255ml;手术完成后患者心率较术前显著降低,收缩压、舒张压、血红蛋白较术前比较均有显著提高(P<0.05);并且恢复至正常水平。结论中央型前置胎盘大出血患者发病急,病情变化快,若不进行及时有效的治疗易导致严重后果,而其往往伴随胎儿宫内窘迫、死胎、失血性贫血等严重并发症,采用口服米非司酮、米索前列醇阴道后穹窿放置终止妊娠联合子宫动脉栓塞术治疗能够有效止血,早期改善患者各项生命体征,同时还可保留生育能力,值得在临床治疗过程中应用。
Objective To analyze the feasibility and clinical effect of central placenta previa bleeding with mifepristone and misoprostol in termination of pregnancy combined with uterine artery embolization. Methods Eighteen patients with central placenta previa who had been selected for treatment were enrolled in this study. All patients were treated with oral mifepristone and misoprostol vaginal fornix for termination of pregnancy and uterine arterial embolization. The clinical data of 18 patients A retrospective analysis was conducted to assess the feasibility and clinical efficacy. Results The operation was successful in all the cases. No vaginal bleeding was observed in 11 cases. Vaginal bleeding stopped immediately after the operation was completed in 11 cases. The vaginal bleeding amount was less than 150 ml in 6 cases and the vaginal bleeding volume was 255 ml in 24 hours after operation. The heart rate Compared with the preoperative, the systolic blood pressure, diastolic blood pressure and hemoglobin were significantly decreased (P <0.05), and returned to normal levels. Conclusion The patients with central placental hemorrhage have acute onset and rapid changes in disease. If not treated promptly and effectively, they may lead to serious consequences. However, they often accompany serious complications such as fetal distress, stillbirth and hemorrhagic anemia. Oral MFF Division ketones, misoprostol vaginal posterior fornix termination of pregnancy combined with uterine artery embolization can effectively stop bleeding, early improvement of the vital signs of patients, but also to retain fertility, it is worth in the clinical treatment process.