腹主动脉球囊阻断术在凶险性前置胎盘剖宫产中的作用

目的 探讨腹主动脉球囊阻断术在凶险性前置胎盘剖宫产中的作用。 方法 回顾性分析2003年3月至2016年3月山东大学附属省立医院产科收治的140例凶险性前置胎盘。术前预置腹主动脉球囊应用于凶险性前置胎盘剖宫产的111例患者为观察组,未行腹主动脉球囊阻断的凶险前置胎盘患者29例为对照组。采用两独立样本t检验及χ2检验分析两组术中出血量、输血量、子宫切除率及术后感染、新生儿窒息率情况。 结果 观察组与对照组比较,术中出血量分别为(2 139.19±1 533.748)mL、(3 968.97±3 103.811)mL;输血量分别为(1 713.06±1 391.495)mL和(3 237.93±2 461.186)mL;差异均有统计学意义(P=0.004, P=0.003);观察组与对照组子宫切除率分别为18.01%(20/111)、79.31%(23/29),差异有统计学意义(P<0.001),观察组子宫切除率明显下降。观察组与对照组术后感染率、新生儿窒息率比较差异均无统计学意义(P=1.000, P=0.634)。 结论 腹主动脉球囊阻断术可有效控制植入性凶险性前置胎盘的术中出血及输血量,降低子宫切除率。

Prophylactic abdominal aorta arteries balloon occlusion in cesarean section for pernicious placenta previa and placenta increta in third trimester

Objective To explore the efficacy of prophylactic abdominal aorta arteries balloon occlusion in cesarean section for pernicious placenta previa and placenta increta. Methods A retrospective analysis was conducted in 140 cases of pernicious placenta previa and placenta increta admitted to our hospital during March 2003 and March 2016. The study group(n=111)underwent prophylactic abdominal aorta arteries balloon placement before cesarean section and occlusion after delivery. The control group(n=29)received conventional haemostasis druring cesarean section. The amount of blood loss and blood transfusion during operation, hysterectomy rate, infection rate and neonatal asphyxia rate of the two groups were compared with T test or Chi-square test. Results The volume of intraoperative hemorrhage and volume of intraoperative blood transfusion in the study group and control group were(2 139.19±1 533.748)mL vs(3 968.97±3 103.811)mL,(1 713.06±1 391.495)mL vs(3 237.93±2 461.186)mL,(P=0.004, P=0.003). The hysterectomy rate in the study group and control group was 18.01%(20/111)vs 79.31%(23/29),(P<0.001). There was no statistical difference in the infection rate and neonatal asphyxia rate(P=1.000, P=0.634). Conclusion Prophylactic abdominal aorta arteries balloon occlusion is effective in reducing intraoperative blood loss, transfusion and hysterectomy rate in patients with pernicious placenta previa and placenta increta.