腹主动脉球囊阻断应用于植入型凶险型前置胎盘剖宫产中的效果

目的 探讨腹主动脉球囊阻断在植入型凶险型前置胎盘产妇剖宫产术中的临床应用效果。方法 回顾性分析18例接受腹主动脉球囊阻断联合剖宫产手术的植入型凶险型前置胎盘产妇的临床资料。记录术中出血量、输血量、球囊阻断有效率、总阻断时间、子宫切除情况及并发症等。结果 18例产妇均成功行腹主动脉球囊阻断辅助剖宫产术，技术成功率为100%（18/18）。剖宫产术中平均出血量为（1 276.11±761.59）ml，平均输入悬浮少白红细胞（2.86±1.51）U，无一例因出血而死亡。球囊阻断有效率100%（18/18），球囊有效阻断时间（24.06±26.19）min。4例（4/18，22.22%）产妇在胎儿娩出后行子宫切除术，均由于胎盘植入严重，甚至广泛侵犯宫颈、膀胱、肠道。剖宫产前后产妇均未出现与球囊阻断、介入栓塞相关的严重并发症。结论 对于凶险型前置胎盘产妇，腹主动脉球囊可以有效阻断血流，减少剖宫产术中出血量、输血量，降低子宫切除率及手术风险。

Effect of the abdominal aortic balloon occlusion applied to caesarean section for pernicious placenta previa and previa accreta

Objective To investigate the clinical curative effect of the abdominal aortic balloon occlusion in caesarean section for pernicious placenta previa and previa accreta. Methods Data of 18 puerperants with pernicious placenta previa and previa accreta who underwent the abdominal aortic balloon occlusion in caesarean section were retrospectively analyzed. The amount of intraoperation blood loss and transfusion, the effective rate of balloon occlusion, the occlusion time, hysterectomy and complications were recorded. Results All the 18 puerperants underwent the abdominal aortic balloon occlusion in caesarean section successly, with the technical success rate was 100% (18/18). The mean amount of blood loss was (1 276.11±761.59)ml during the caesarean section. And the mean amount of leukoreduced red blood cells transfusion was (2.86±1.51)U. No puerperant was dead of bleeding. The effectiveness of the abdominal aortic balloon occlusion was 100% (18/18), with the occlusion time was (24.06±26.19)min. Four (4/18, 22.2%) puerperants were underwent the hysterectomy due to serious placenta implantation, which even extensively invaded the cervix, bladder and intestine. No serious complications related to the abdominal aortic balloon occlusion and the interventional embolization were occured during the caesarean section. Conclusion For the puerperants with pernicious placenta previa and previa accreta, the abdominal aortic balloon can effectively block blood flow, reduce the amount of blood loss and transfusion during caesarean section, and reduce the rate of hysterectomy and the risk of the operation.