腹主动脉球囊阻断在凶险性前置胎盘合并胎盘植入剖宫产术中的临床疗效

Clinical efficacy of temporary balloon occlusion of the abdominal aorta in cesarean section for pernicious placenta previa complicating by placenta implantation

目的探讨在凶险性前置胎盘合并胎盘植入行剖宫产术中应用腹主动脉球囊阻断的临床效果。方法选取2015年8月至2017年1月期间妇产科所收治凶险性前置胎盘合并胎盘植入产妇67例，所有产妇均行剖宫产手术，其中58例于术前接受腹主动脉球囊导管预置术，术中对腹主动脉血流进行暂时阻断（观察组）；9例患者仅接受常规剖宫产手术（对照组），对两组产妇手术情况及其并发症发生清况进行观察分析。结果观察组产妇术中出血量、手术时间、术中PT值均明显优于对照组，差异有统计学意义（P〈0．05）。本次研究中，观察组产妇58例均未实施子宫切除，对照组中2例产妇行子宫切除，观察组产妇子宫切除率明显低于对照组，差异有统计学意义（P〈0．05）。结论在凶险性前置胎盘合并胎盘植入产妇剖宫产术中行腹主动脉球囊阻断，可有效减少术中出血，有利于保护产妇子宫功能，对于降低手术风险，促进其术后康复具有十分积极的作用，建议在临床推广应用。

Objective To explore the clinical effect of temporary balloon occlusion of the abdominal aorta in cesarean section for pernicious placenta previa complicating by placenta implantation. Methods A total of 67 cases of pernicious placenta previa complicating by placenta implantation in the department of obstetrics and gynecology from August 2015 and January 2017 were selected and underwent cesarean section. 58 cases of whom received temporary balloon occlusion of the abdominal aorta （observation group）, other 9 cases received conventional cesarean section （control group）. The condition of operation and the complications of the two groups were compared. Results The intraoperative blood loss, operation time, and intraoperative PT level in the observation group were significantly better than those in the control group （P〈0.05）. In this study, there was no hysterectomy case in the observation group, while there were 2 cases of hysterectomy in the control group, the rate of hysterectomy in the observation group was significantly lower than that in the control group, with statistically significant difference （P〈0.05）. Conclnsion Temporary balloon occlusion of the abdominal aorta in cesarean section for pernicious placenta previa complicating by placenta implantation can effectively reduce intraoperative bleeding, is conducive to the protection of maternal uterine function, has a very positive role in reducing the risk of surgery and promoting the postoperative rehabilitation, is recommended in the clinical application.