超声引导下腹主动脉球囊封堵术在凶险性前置胎盘剖宫产 术中的应用研究

目的 探讨超声引导下腹主动脉球囊封堵术在凶险性前置胎盘剖宫产中的临床疗效。方法 选取2017年1月~2018年6月在我院住院治疗的凶险性前置胎盘孕妇93例，其中42例在超声引导下行腹主动脉球囊置管术后直接行剖宫产术的孕妇设为观察组，51例直接行剖宫产术，术中止血带捆绑子宫下段的孕妇设为对照组。比较两组孕妇术中、术后情况及新生儿出生情况。结果 观察组手术时间、术中出血量≥1000 ml、输血量≥600 ml、子宫切除率、凝血功能障碍发生率均低于对照组，住院费用高于对照组（P＜0.05）；两组术中术后并发症发生率、术后住院时间、新生儿窒息率比较，差异无统计学意义（P＞0.05）。结论 通过多学科联合，在超声引导下行腹主动脉球囊阻断术能够有效控制凶险性前置胎盘患者剖宫产术中引起的大出血，降低子宫切除率及输血需求，避免了胎儿接受放射线照射。

Application of Ultrasound-guided Abdominal Aortic Balloon Occlusion in Cesarean Section of Sinister Placenta Previa

Abstract:Objective To investigate the clinical efficacy of ultrasound-guided abdominal aortic balloon occlusion in cesarean section of sinister placenta previa. Methods A total of 93 pregnant women with antenatal placenta who were hospitalized in our hospital from January 2017 to June 2018 were enrolled. Among them, 42 patients underwent cesarean section after ultrasound-guided abdominal aortic balloon catheterization. In the observation group, 51 patients underwent cesarean section directly, and the pregnant women with the hemostatic band tied to the lower uterus were set as the control group. The intraoperative and postoperative conditions and neonatal birth status of the two groups of pregnant women were compared. Results The operation time min, intraoperative blood loss ≥1000 ml, blood transfusion ≥600 ml, hysterectomy rate, coagulation dysfunction occurred in the observation group. The rate was lower than that of the control group(P<0.05); the hospitalization cost of the observation group was higher than that of the control group(P<0.05); the incidence of postoperative complications in the two groups, postoperative hospital stay, neonatal asphyxia rate, the difference was not statistically significant(P>0.05).Conclusion By multi-disciplinary combination, ultrasound-guided abdominal aortic balloon occlusion can effectively control the hemorrhage caused by cesarean section in sinister placenta previa, reduce the rate of hysterectomy and blood transfusion, and avoid fetal radiation exposure.