腹主动脉球囊阻断在凶险性前置胎盘剖宫产术中的应用

Application of Abdominal Aortic Balloon Occlusion in Dangerous Placenta Previa Cesarean Section

目的:探讨在凶险性前置胎盘剖宫术中采取腹主动脉球囊阻断术的效果。方法:在2018年6月~2020年6月期间来某院就诊的凶险性前置胎盘剖宫术患者中选取48例,根据随机数字表法分为对照组和研究组各24例。对对照组行常规治疗,对研究组行腹主动脉球囊阻断术治疗,对比两组患者胎盘植入情况以及术中出血量、术中输血量、手术时间、子宫切除率、住院时间、新生儿评分(APgar)等指标情况。结果:研究组胎盘植入情况相比于对照组较高,组间差异性显著(P<0.05);研究组术中出血量、术中输血量、子宫切除率等明显优于对照组(P<0.05);两组患者手术时间、住院时间、APgar评分经统计学比较无显著差异(P>0.05)。结论:在凶险性前置胎盘剖宫术中采取腹主动脉球囊阻断术,将子宫切除率、术中出血情况降低,但存在血栓风险,对于大面积穿透性植入患者需实施子宫切除治疗。

Objective:To investigate the effect of balloon occlusion of abdominal aorta in dangerous placenta previa.Methods:48 patients with dangerous placenta previacesarean section in a hospital from June 2018 to June 2020 were selected and grouped according to the random number table method,with 24 patients in each group.The control group received conventional treatment and the study group received abdominal aortic balloon occlusion.The conditions of placenta implantation,intraoperative blood loss,intraoperative blood transfusion,operative time,hysterectomy rate,length of hospital stay,neonatal score(APgar)and other indicators of two groups were compared.Results:Placenta implantation in the study group was higher than that in the control group,and the difference between the two groups was significant(P<0.05).The amount of intraoperative blood loss,intraoperative blood transfusion and uterine resection rate in the study group were significantly better than those in the control group(P<0.05).There was no significant difference in operation time,length of hospital stay and APgar score between the two groups(P>0.05).Conclusion:Balloon occlusion of abdominal aorta in the dangerous placenta previa operation can reduce the hysterectomy rate and intraoperative bleeding,but there is a risk of thrombosis.Therefore,hysterectomy should be performed for patients with large penetrating implantation.