Fogarty腹主动脉球囊导管预置阻断术在凶险性前置胎盘产妇中的应用

The application of prophylactic abdominal aorta balloon occlusion with Fogarty catheter in treating patients with pernicious placenta previa

目的探讨对凶险性前置胎盘产妇剖宫产术前施行Fogarty腹主动脉球囊导管预置阻断术的临床疗效。方法回顾性分析12例凶险性前置胎盘产妇剖宫产术前接受Fogarty动脉取栓导管腹主动脉球囊预置术产妇临床资料,评价治疗效果。结果 12例产妇剖宫产术中出血量为平均(1256±318)ml;9例成功保留子宫,3例出现难治性出血接受子宫切除术(其中1例胎盘穿透至膀胱接受全子宫切除、膀胱修补术)。产后均未发生感染、晚期出血、下肢血栓等并发症。12例新生儿均顺利出生。结论 Fogarty腹主动脉球囊导管预置阻断术可减少术中出血量,有助于保留子宫,是凶险性前置胎盘产妇剖宫产前安全有效的治疗方法。

Objective To discuss the clinical effect of prophylactic abdominal aorta balloon occlusion with Fogarty catheter before cesarean section in treating delivery woman with pernicious placenta previa. Methods The clinical data of 12 delivery women with pernicious placenta previa, who received prophylactic abdominal aorta balloon occlusion with Fogarty catheter before cesarean section, were retrospectively analyzed. The curative effect was evaluated. Results The average intraoperative blood loss in the 12 patients was （1256-＋318） ml. The uterus was successfully retained in 9 patients. Hystcrectomy had to be carried out in 3 patients because of refractory hemorrhage; one of them had to receive total hysterectomy together with bladder repair as the placenta had penetrated into the bladder walk After delivery no complications, such as infection, delayed hemorrhage, lower limb thrombosis, etc., occurred. All 12 neonates were born smoothly. Conclusion Prophylactic abdominal aorta balloon occiusion with Fogarty catheter before cesarean section can effectively reduce intraoperative blood loss and help save the uterus. Therefore, it is a safe and effective therapeutic means for delivery woman with pernicious placenta previa before the performance of cesarean section.（J Intervent Radiol, 2018, 27： 67-70）