腹主动脉球囊阻断联合宫腔填塞预防前置胎盘产后出血

Combination of Abdominal Aorta Balloon Block and Uterine Packing in Prevention of Placenta Previa Postpartum Hemorrhage

目的总结前置胎盘患者置入腹主动脉球囊,联合宫腔填充预防剖宫产术后出血的围术期管理经验。方法回顾性分析9例前置胎盘患者(其中6例合并胎盘植入)资料,均在剖宫产术前放置腹主动脉球囊,术中娩出胎儿后充盈球囊并剥离胎盘,运用Bakri球囊宫腔内填塞止血。结果 9例患者手术均成功,其中采用全身麻醉和椎管内麻醉为5:4,术中平均出血量(633±327)m L,输液量(1227±576)m L,阻断时间(27±8)min。结论腹主动脉球囊阻断联合宫腔填塞能够预防前置胎盘产后出血,此类剖宫产术宜采用全身麻醉。

Objective To draw conclusion of management experience of patients with placenta previa placing in abdominal aortic balloon combined with uterine packing in prevention of hemorrhage after cesarean section in perioperative period. Methods Retrospective analysis of 9 cases of patients with placenta previa（ 6 cases combined with placenta implantation） showed that they were both placed in abdominal aortic balloon before cesarean section. Patients were filled with balloon and stripped with the placenta after delivery of baby and used Bakri balloon intrauterine packing for hemostasis. Results Surgery of 9 cases were all successful and the propotion of which adopted the general anesthesia and intravertebral anesthesia was 5： 4. Intraoperative mean bleeding volum was（ 633±327） m L,infusion volume was（ 1227±576） m L and blocking time was（ 27±8） min. Conclusion Abdominal aorta balloon block combined uterine packing can prevent placenta previa postpartum hemorrhage and this kind of cesarean section is appropriate to general anesthesia.