低位腹主动脉压迫法在凶险性前置胎盘子宫切除中的应用价值

Application value of lower abdominal aorta compression in hysterectomy for pernicious placenta previa

目的探讨低位腹主动脉压迫法在凶险性前置胎盘剖宫产手术中紧急切除子宫并控制出血的临床价值。方法回顾性分析2016年1月—2017年3月期间,在四川省妇幼保健院采用低位腹主动脉压迫法完成的4例凶险性前置胎盘围手术期子宫切除病例的临床资料。结果 4例患者手术均成功,母儿平安,无盆腔脏器损伤,未发现腹主动脉压迫相关的并发症。结论低位腹主动脉压迫法可以有效地争取子宫切除的手术时间,协助完成紧急子宫切除,具有对母体血液循环影响小、手术视野清晰、术中出血量少、并发症少、简单可行等优势,值得进一步在术中大出血抢救病例中推广。特别是在无条件进行血管介入治疗的医院或急诊情况下,低位腹主动脉压迫法更是值得提倡的急救措施。

Objective To explore the value of lower abdominal aorta compression in emergent hysterectomy during cesarean section because of pernicious placenta previa. Method We retrospectively analyzed the clinical data of four patients who underwent hysterectomy for pernicious placenta previa with the assistance of lower abdominal aorta compression between January 2016 and March 2017 in Sichuan Provincial Hospital for Women and Children. Result The four patients were cured successfully, and the mothers and babies were all well with no pelvic organ damage or complications related to lower abdominal aorta compression. Conclusions Lower abdominal aorta compression in hysterectomy for pernicious placenta previa during cesarean section is a feasible procedure; it can effectively reduce the amount of bleeding, less affect maternal blood circulation, make surgery area clear, and give the operators the chance to do hysterectomy calmly. Lower abdominal aorta compression presents more and more advantages to treat pernicious placenta previa and may be an effective emergency measure to reduce hemorrhage during perioperative period especially under the circumstances of no chance to carry out vascular intervention treatment.