高强度聚焦超声与子宫动脉栓塞治疗胎盘植入患者。
High-intensity focused ultrasound versus uterine artery embolization for patients with retained placenta accreta.
机构信息
Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China.
Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China.
出版信息
Eur J Obstet Gynecol Reprod Biol. 2020 Sep;252:82-86. doi: 10.1016/j.ejogrb.2020.06.003. Epub 2020 Jun 8.
OBJECTIVE
To compare the safety and clinical effectiveness of high-intensity focused ultrasound (HIFU) and uterine artery embolization (UAE) for retained placenta accreta.
STUDY DESIGN
A retrospective analysis was performed on women who underwent HIFU or UAE followed by hysteroscopic resection for retained placenta accreta from January 2015 to December 2019 at the Third Xiangya Hospital of Central South University.
RESULTS
A total of 63 and 31 patients who underwent HIFU and UAE followed by hysteroscopic resection, respectively, were analyzed. The baseline characteristics, including age, gravidity, parity, previous cesarean section rate, previous curettage rate, previous intrauterine adhesions rate, and delivery mode, were similar between the two groups. Vaginal bleeding was the major complaint in patients with retained placenta accreta. The number of hysteroscopy sessions, amount of intraoperative blood loss, and the length of hospital stays were also similar between the groups. No further hysterectomy was needed in either group.
CONCLUSION
Both HIFU and UAE combined with hysteroscopic resection seem to be safe and effective procedures in cases of retained placenta accreta.
目的
比较高强度聚焦超声（HIFU）和子宫动脉栓塞术（UAE）治疗胎盘植入的安全性和临床疗效。
研究设计
对 2015 年 1 月至 2019 年 12 月期间在中南大学湘雅三医院接受 HIFU 或 UAE 联合宫腔镜切除术治疗胎盘植入的患者进行回顾性分析。
结果
共分析了 63 例和 31 例分别接受 HIFU 和 UAE 联合宫腔镜切除术的患者。两组患者的基线特征，包括年龄、孕次、产次、剖宫产率、刮宫率、宫腔粘连率和分娩方式，均相似。阴道出血是胎盘植入患者的主要主诉。两组的宫腔镜检查次数、术中出血量和住院时间也相似。两组均无需进一步行子宫切除术。
结论
对于胎盘植入，HIFU 和 UAE 联合宫腔镜切除术似乎是安全有效的治疗方法。
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