髂内动脉球囊阻断术在植入型凶险性前置胎盘剖宫产术中的应用疗效分析

目的探讨髂内动脉球囊阻断术在植入型凶险性前置胎盘剖宫产术中的应用价值。方法选择凶险性前置胎盘伴胎盘植入产妇86例临床资料，其中50例选择髂内动脉球囊阻断术（球囊组），36例仅行剖宫产术（对照组）。比较2组术中出血量、术中输血量、手术时间、术后住院时间、子宫切除率及相关并发症。结果球囊组术中出血量（1 585.3±769.9）mL及术中输红细胞量（4.5±3.8）U，均小于对照组术中出血量（2 044.1±1 362.9）mL及术中输红细胞量（6.8±4.9）U（P < 0.05）；球囊组子宫切除率40.00%，膀胱损伤率12.00%，与对照组子宫切除率44.44%、膀胱损伤率11.11%，差异均无统计学意义（P>0.05）；球囊组有1例发生术后右下肢动脉血栓，对照组未发生。结论植入型凶险性前置胎盘剖宫产术中采用髂内动脉球囊阻断术，可减少出血量及输血量，并不能有效降低子宫切除率，且有血栓形成风险。

Analysis of the application value of internal iliac artery balloon occlusion in cesarean section patients with pernicious placenta previa

ObjectiveTo explore the application value of the internal iliac artery balloon occlusion in cesarean section patients with pernicious placenta previa (PPP).MethodsThe clinical data of 86 puerperas were retrospectively analyzed.Fifty cases treated with internal iliac artery balloon occlusion and 36 cases treated with cesarean section were divided into the balloon group and control group, respectively.The operative time, intraoperative blood loss, intraoperative blood transfusion, hysterectomy rate, postoperative hospital stay and related complications were compared between two groups.ResultsThe intraoperative blood loss and intraoperative red blood cell transfusion in balloon group[ (1 585.3±769.9)mL, (4.5±3.8)U] were less than those in control group[ (2 044.1±1 362.9)mL, (6.8±4.9)U], respectively (P < 0.05).The hysterectomy rate and bladder injury rate in balloon group and control group were (40.00%, 12.00%) and (44.44%, 11.11%), respectively, and the difference of which was not statistically significant (P>0.05).One case of right lower extremity artery thrombosis occurred in balloon group.ConclusionsThe internal iliac artery balloon occlusion in cesarean section patients with PPP can reduce the amount of intraoperative blood loss and blood transfusion, but not effectively reduce the rate of uterine resection, and has a risk of occuring thrombus.