腹主动脉球囊阻断术在前置胎盘产妇中的应用分析

The abdominal aorta balloon block technique applied in preplacental pregnant women

目的探讨前置胎盘产妇剖宫产术中应用腹主动脉球囊阻断术的效果及方法。方法 2015年10月1日至2016年10月31日,在安徽医科大学附属妇幼保健院就诊的前置胎盘产妇22例,采用腹主动脉球囊阻断术后行剖宫产术,对孕妇的手术情况、术中出血量、输血情况、术中和术后并发症以及新生儿预后进行分析。结果 22例孕妇中凶险型前置胎盘20例、中央性前置胎盘并发胎盘植入1例、中央性前置胎盘合并血小板减少1例。腹主动脉球囊充水量7(5~9)m L,术中出血量1 000(600~1 625)m L,12例输注血制品。术中均配合应用各种保守性手术方法止血,6例术后行子宫动脉栓塞术,2例行子宫切除术,1例术后出现休克并发阔韧带血肿,新生儿轻度窒息3例。结论对高危类型的前置胎盘患者在剖宫产术前行腹主动脉球囊预置术,可有效减少术中出血,降低子宫切除的风险;该方法简便易行,便于在基层医院推广。

Objective To explore the effect of abdominal aortic balloon blockage in the preplacental pregnant women. Method Retrospective analysis was conducted on the preplacental situation of 22 cases from Oct. 1 st,2015 to Oct. 31 st,2016. An interventional physician performed right femoral artery puncture and preset the abdominal aortic balloon catheter in the DSA operation room before cesarean. Condition of placenta implantation,blood loss and blood transfusion during the operation,intraoperative and postoperative complications,and Apgar score of neonates were analyzed. Results Among the 22 cases,pernicious placenta previa were 20 cases,complete preplacental were 2 cases. For all cases,ventral aorta balloon water filling 7（5-9） m L,the mean blood loss in the operation was1 000（600-1 625） m L,among which,12 cases received blood transfusion,6 cases received treatment combined with uterine artery embolization and 2 cases received hysterectomy,and 3 neonates with mild asphyxia. Conclusion Abdominal aortic balloon catheter in preplacental patients might effectively reduce the blood loss during cesarean section as well as the risk of hysterectomy through temporary occlusion of the abdominal aorta.