髂内动脉预置球囊与子宫动脉栓塞术预防前置胎盘产后出血的临床效果比较

Comparison of Clinical Effect between Internal Iliac Artery Presetting Balloon and Uterine Artery Embolization in Prevention of Postpartum Hemorrhage of Placenta Previa

目的观察髂内动脉预置球囊与子宫动脉栓塞术预防前置胎盘产后出血的临床效果。方法选择2014年1月—2016年12月收治的64例前置胎盘,按照治疗方式分为研究组和对照组,每组32例。研究组给予髂内动脉预置球囊后再行剖宫产术,对照组给予子宫动脉栓塞术后行剖宫产术。观察2组术中及术后指标,记录并发症发生情况。结果 2组术中手术时间、术中止血时间、术中出血量、产后24 h出血量、产后住院时间、子宫切除率、新生儿窒息率、产褥病率及产后出血率比较差异无统计学意义(P>0.05)。研究组术后并发症发生率低于对照组(P<0.05)。结论髂内动脉预置球囊术与子宫动脉栓塞术均能有效控制前置胎盘产后大出血,但髂内动脉预置球囊的安全性优于子宫动脉栓塞术。

Objective To observe clinical effects of internal iliac artery presetting balloon and uterine artery embolization in prevention of postpartum hemorrhage of placenta previa. Methods A total of 64 patients with placenta previa admitted during January 2014 and December 2016 were divided into study group （ n = 32） and control group （ n = 32） according to different treatment methods. Study group was treated with internal iliac artery presetting balloon before cesarean section, while control group was treated with uterine artery embolization before cesarean section. In two groups, intraoperative and postoperative indexes were observed, and incidence rates of complications were recorded. Results There were no significant differences in operative time, intraoperative hemostatic time, intraoperative volume of blood loss, within postpartum 24h bleeding volume, postpartum hospitalization time, hysterectomy rate, neonatal asphyxia rate, puerperal morbidity rate and postpartum hemorrhage rate between the two groups （P 〉 0.05 ）. Incidence rate of postoperative complications in study group was significantly lower than that in control group （ P 〈 0.05 ）. Conclusion Both internal iliac artery presetting balloon and uterine artery embolization can effectively control postpartum hemorrhage of placenta previa, but internal iliac artery presetting balloon may achieve better safety than that by uterine artery embolization.