腹主动脉阻断球囊预植入术对凶险性前置胎盘剖宫产术中止血情况及手术结局的影响

目的探讨腹主动脉阻断球囊预植入术对凶险性前置胎盘剖宫产术中止血及手术结局的影响。方法回顾性分析成都医学院第一附属医院收治的凶险性前置胎盘患者62例的临床资料,其中2013年9月至2014年8月直接采用剖宫产治疗的31例为对照组,2014年9月至2015年8月采用腹主动脉阻断球囊预植入术治疗的31例为研究组。对比两组手术基本情况(手术时间、术中出血量、输血量、住院时间)及手术结局(转ICU率、子宫切除、新生儿窒息、下肢血栓)。结果研究组手术时间、术中出血量、输血量、住院时间、转ICU率、子宫切除的发生率显著低于对照组,差异有统计学意义(P0.05);两组新生儿窒息、下肢血栓的发生率比较差异无统计学意义(P0.05)。结论腹主动脉阻断球囊预植入术在凶险性前置胎盘剖宫产术中的止血效果良好,且能显著降低子宫切除率。

Effects of pre-implantation of abdominal aortic occlusion balloon on hemostasis and outcome of cesarean section of dangerous placenta previa

Objective To investigate the effect of pre-implantation of abdominal aortic occlusion balloon on hemostasis and outcome of cesarean section of dangerous placenta previa.Methods The clinical data of 62 patients with malignant placenta previa in The First Affiliated Hospital of Chengdu Medical College were analyzed retrospectively.Among them, 31 cases treated by cesarean section from September 2013 to August 2014 were selected as control group, and 31 patients treated with abdominal aorta block balloon implantation before cesarean section from September 2014 to August 2015 were selected as the study group.The surgery (operation time, intraoperative blood loss, blood transfusion, length of hospital stay) and surgical outcome (ICU, hysterectomy, neonatal asphyxia, lower limb thrombosis) of two groups were compared.Results The operation time, blood loss during operation, blood transfusion and length of hospital stay of the study group were significantly lower than those in the control group.The difference was statistically significant (P<0.05).The incidence of ICU and hysterectomy in the study group was significantly lower than that in the control group.The difference was statistically significant (P<0.05).The incidence of neonatal asphyxia and lower limb thrombosis of the two groups has no significant difference (P>0.05).Conclusion The hemostatic effect of pre-implantation of abdominal aortic occlusion balloon during cesarean section of dangerous placenta previa is good, and can significantly reduce the rate of hysterectomy.