髂内动脉球囊预置封堵术应用于胎盘植入的meta分析

Prophylactic internal iliac artery balloon catheterization in patients with placenta accrete: a meta-analysis

目的评价髂内动脉球囊预置封堵术用于胎盘植入治疗的价值。方法检索中英文文献数据库,收集关于髂内动脉球囊预置封堵术用于胎盘植入的文献,进行文献筛选和质量评价,采用Rev Man 5.3软件对这些文献进行meta分析。结果共纳入9篇文献,均为回顾性队列研究,文献质量评价均为7分以上。meta分析结果显示:与对照组相比,干预组患者的剖宫产术中的出血量及输血量及手术时间、产妇术后住院天数均有减少,差异有统计学意义(P<0.05)。而两组子宫切除率、产妇术中术后的并发症、产妇剖宫产前后血红蛋白减少量差异无统计学意义(P>0.05)。结论髂内动脉球囊预置封堵术,可以减少胎盘植入患者剖宫产术中的出血量和输血量,缩短手术时间和住院时间。

Objective To evaluate the efficacy of prophylactic internal iliac artery balloon catheterization in patient with placenta accrete. Methods Chinese and English databases were searched for studies of prophylactic internal iliac arteries balloon catheterization in management of placenta accreta. The relevant literature was screened and the quality was assessed. Meta-analysis was performed by using RevMan 5.3. Results Nine retrospective cohort studies involving 445 cases were included, all of which had a score of higher than 7 in assessment using NOS. The results from meta- analysis showed that the patients in the interventional group had a significant decrease in intraoperative blood loss, blood transfusion, operational time, and postoperative hospital stay as compared with the control group（P 〈 0.05 ）. Conclusion Prophylactic internal iliac artery balloon catheterization can reduce the intraoperative blood loss and blood transfusion, shorten the operative time of the followed cesarean delivery as well as postoperative hospital stay.