中国妇幼健康研究2017，Vol.28Issue(4)：469-471,3.DOI:10.3969/j.issn.1673-5293.2017.04.036
宫腔镜下清宫术联合甲氨蝶呤灌注及栓塞治疗胎盘植入的疗效观察
Curative effect of curettage under hysteroscope combined with methotrexate infusion and embolization in treatment of placenta accreta
罗玉辉 1任黔川 2魏宇3
作者信息
- 1. 泸州市中医医院妇产科,四川泸州646000
- 2. 西南医科大学附属医院妇产科,四川泸州646000
- 3. 泸州市中医医院血管外科,四川泸州646000
- 折叠
摘要
Abstract
Objective To study the curative effect of curettage under hysteroscope combined with methotrexate (MTX) infusion and embolization via uterine artery in treatment of placenta accreta.Methods Totally 30 cases with placenta accreta were selected during January 2014 to October 30th in 2016 in department of obstetrics and gynecology in Luzhou Hospital of Traditional Chinese Medicine.Bilateral uterine arteries selective catheterization through 5 F catheters were performed in all patients,which were followed by slow infusion of MTX and subsequent bilateral uterine artery embolization with gelatin sponge particles.Hysteroscopy curettage was undergone in patients who could not spontaneously discharge the placenta within 1 to 2 weeks after surgery.Results MTx infusion and embolization via uterine artery was obtained in all patients successfully.In 19 cases presenting massive hemorrhage,bleeding in 12 cases was stopped immediately after surgery,and bleeding in 7 cases was stopped gradually in 1.0 to 4.5 hours.The placentas were spontaneously discharged through vagina in 13 cases within l week,while 17 cases who didn't discharge the placentas spontaneously had to receive hysteroscopic curettage in 1-2 weeks after surgery.The placenta accreta tissues in all of the 30 cases were completely eliminated by single procedure.The blood β-human chorionic gonadotropin level dropped to normal range in 2-6 weeks after surgery.Uterine perforation,ectopic embolism,intrauterine infection and adhesions as well as other postoperative complications were not observed in all patients.Conclusion The curative effect of curettage under hysteroscope combined with methotrexate (MTX) infusion and embolization via uterine artery in treatment of placenta accreta is effective,safe and reliable.So it deserves to be promoted and applied in clinical work.关键词
宫腔镜/清宫术/子宫动脉栓塞/胎盘植入Key words
hysteroscopy/uterine curettage/uterine artery embolization/placenta accreta分类
医药卫生引用本文复制引用
罗玉辉,任黔川,魏宇..宫腔镜下清宫术联合甲氨蝶呤灌注及栓塞治疗胎盘植入的疗效观察[J].中国妇幼健康研究,2017,28(4):469-471,3.
