CAJ | 학술논문

目的：探讨子宫动脉化疗栓塞术（UACE）在前置胎盘中期妊娠并阴道出血引产术中的价值。方法对10例前置胎盘中期妊娠并阴道出血需终止妊娠患者，先行双侧子宫动脉化疗栓塞术，再行依沙吖啶羊膜腔内注射术引产，观察引产前、引产中、术后出血及产后恢复情况。结果10例患者栓塞术后阴道出血停止，羊膜腔穿刺注入依沙吖啶后6～24 h娩出死胎，分娩后阴道流血量80～150 ml，平均100 ml，7～10 d子宫复旧，42～96 d月经复潮，月经周期和月经量与孕前相仿。结论子宫动脉化疗栓塞术为前置胎盘中期妊娠并阴道出血需终止妊娠患者提供了一种控制引产前出血、预防产后大出血的安全有效措施，介入治疗序贯药物引产术可作为前置胎盘引产的新策略。
목적：탐토자궁동맥화료전새술（UACE）재전치태반중기임신병음도출혈인산술중적개치。방법대10례전치태반중기임신병음도출혈수종지임신환자，선행쌍측자궁동맥화료전새술，재행의사아정양막강내주사술인산，관찰인산전、인산중、술후출혈급산후회복정황。결과10례환자전새술후음도출혈정지，양막강천자주입의사아정후6～24 h면출사태，분면후음도류혈량80～150 ml，평균100 ml，7～10 d자궁복구，42～96 d월경복조，월경주기화월경량여잉전상방。결론자궁동맥화료전새술위전치태반중기임신병음도출혈수종지임신환자제공료일충공제인산전출혈、예방산후대출혈적안전유효조시，개입치료서관약물인산술가작위전치태반인산적신책략。
Objective To evaluate the efficacy of uterine artery chemoembolization(UACE)before induced labor for treatment of life-threatening second trimester vaginal hemorrhage from placenta previa.Methods Ten patients with second trimester vaginal hemorrhage from placenta previa underwent bilateral uterine arterial chemoembolization and intraamniotic injection of ethacridine. The amount of hemorrhage before,during and after induction of labor was recorded as well as postpartum recovery.Results Active vaginal hemorrhage was stopped after UACE in all women and the dead fetuses were delivered at 6-24 hours after induction of labor with ethacridine.The volume of vaginal bleeding was 80-150 mL with average of 100 mL after delivery.The uteruses returned to normal after 7 to 10 days and menstruation resumed in 42 to 96 days.Conclusion UACE combined with induced labor is safe and effective for treatment of second trimester vaginal hemorrhage from placenta previa.