超声引导下腹主动脉预置阻断球囊减少高危前置胎盘手术出血

Ultrasound-guided intraabdominal aortic balloon control technique for reducing intraoperative hemorrhage of high-risk placenta previa

目的探讨超声引导下腹主动脉预置阻断球囊减少高危前置胎盘手术出血的临床应用价值。方法2013年8月至2017年10月共收治高危性前置胎盘并有胎盘植入的剖宫产患者40例，其中16例患者（研究组）于剖宫产术前实施超声引导下预置腹主动脉球囊，术中间断阻断腹主动脉；24例未行球囊阻断的患者仅行剖宫产术（对照组），对比两组术中出血量、输血量、子宫缝合时间、术后凝血酶原时间（PT）、ALT、AST、肌酐值及术后并发症。结果术后两组的子宫缝合时间（t=10．34，P=0．001），术中出血量（t=9．51，P=0．001）、输血量（t=3．41，P=0．005），相比差异均有统计学意义。术后两组PT值（t=1．02，P=0．32），ALT（t=0．54，P=0．59），AST（t=0．91，P=0．37），肌酐值（t=0．75，P=0．46），相比差异均无统计学意义。结论超声引导下腹主动脉阻断球囊能有效减少高危前置胎盘剖宫产手术出血。

Objective To explore the value of ultrasound-guided balloon control technique in abdominal aorta for reducing intraoperative hemorrhage in high-risk placenta previa undergoing cesarean section. Methods From Aug 2013 to Oct 2017, 40 cases were admitted, among them, 16 cases were treated with ultrasound-guided towed balloon prophylactic control technique of abdominal aorta （ the study group） before cesarean, and 24 cases did not receive balloon occlusion （the control group） during the cesarean. Clinical data were compared between the two groups. Results The time used for uterine suture （t = 10. 34,P =0. O1 ） ,the amount of intraoperative blood loss （t =9.51 ,P =0. 01 ） and blood transfusion （t = 3.41,P =0. 005）in the two groups were all statistically different. While the differences in PT （t = 1.02,P = 0.32）, ALT （t =0.54,P=0.59）,AST（t =0.91,P=0.37）,creatinine（t =0.75,P=0.46） were not statistically significant between the two groups. Conclusion Ultrasound-guided abdominal aortic balloon control technique can reduce the blood loss significantly in cesarean section with high-risk placenta previa.