双侧髂内动脉球囊封堵术应用于凶险性前置胎盘剖宫产术中的研究

Clinical study on the application of bilateral iliac artery balloon occlusion in cesarean section for pernicious placenta previa

目的探究与分析双侧髂内动脉球囊封堵术应用于凶险性前置胎盘剖宫产术中的临床效果。方法选取川北医学院附属医院自2015年1月至2016年1月收治的80例凶险性前置胎盘剖宫产产妇,采取随机数字表法分为对照组与观察组,每组各40例,对照组给予腹主动脉球囊置管治疗,观察组给予双侧髂内动脉球囊封堵术治疗,对比两组孕妇的术中及术后情况、新生儿生长发育情况。结果对照组与观察组术后体温、输血、子宫切除率及术后住院时间相比无明显差异(t/χ~2值分别为0.78、0.99、1.25、0.87,均P>0.05)。观察组较对照组剖宫产手术时间短、剖宫产术中出血量少,差异具有统计学意义(t值分别为4.26、5.11,均P<0.05)。对照组与观察组新生儿性别、出生体质量及出生身高相比无明显差异(t/χ~2值分别为1.02、0.91、1.04,均P>0.05);对照组Apgar评分低于观察组,差异具有统计学意义(t=4.89,P<0.05)。两组随访3个月、6个月、12个月新生儿体质量及身高比较均无明显差异(t=0.23~0.88,均P>0.05)。结论双侧髂内动脉球囊封堵术应用于凶险性前置胎盘剖宫产术中能够减少术中出血量,降低并发症发生率,安全性较高。

Objective To explore and analyze the clinical effect of bilateral internal iliac artery balloon occlusion on cesarean section for patients with pernicious placenta previa.Methods A total of 80 puerperae with pernicious placenta previa undergoing cesarean delivery in the Affiliated Hospital of Sichuan North Medical College during January 2015 to January 2016 were selected and were divided into control group and observation group by random number table method with 40 cases in each group.The patients in the control group received abdominal aorta balloon catheterization,while the patients in the observation group were treated with bilateral iliac artery balloon occlusion.The intraoperative and postoperative situations of pregnant women and the newborn growth and development condition were compared between two groups.Results There were no significant differences in postoperative body temperature,blood transfusion,hysterectomy rate and hospital stay between two groups（t/χ~2 value was 0.78,0.99,1.25 and0.87,respectively,all P0.05）.Compared with the control group,the observation group had shorter operation time and less blood loss during cesarean section,and the differences were statistically significant（t value was 4.26 and 5.11,respectively,both P0.05）.And there were no significant differences in gender,birth weight and birth height of neonates between two groups（t/χ~2 value was 1.02,0.91 and 1.04,respectively,all P0.05）.The Apgar scores in the control group were lower than those in the observation group,and the difference was statistically significant（t=4.89,P0.05）.Followed up for 3 months,6 months and 12 months,the body weight and height of neonates were not significantly different（t value ranged 0.23-0.88,all P 0.05）.Conclusion The bilateral iliac artery balloon occlusion in cesarean section for patients with pernicious placenta previa can reduce the blood loss volume during surgery and reduce the incidence of complications with high security.