探讨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应用价值

Evaluation on the Value of Abdominal Aortic Balloon Occlusion in the Caesarean Section of Severe Placenta Previa with Placenta Accreta

目的总结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使用价值。方法收集2015年3月—2017年12月于该院住院70例凶险性前置胎盘合并胎盘植入患者临床资料,采用数字表随机原则分为两组各35例,对照组病例在剖宫产术前未接受腹主动脉球囊导管预置术,观察组则于剖宫产术前接受腹主动脉球囊导管预置术,比较两组手术情况(包括手术时间、术中出血量),以及产妇、新生儿结局。结果 (1)观察组手术时间(63.79±4.30)min、术中出血量(920.56±197.58)mL等数值明显低于对照组(91.79±8.25)min、(2 789.52±331.52)m L,差异有统计学意义(t=17.805,-28.650,P<0.05);(2)观察组产妇子宫切除率(8.57%)、重症监护病房转入率(11.43%)明显低于对照组(22.86%、25.71%),差异有统计学意义(χ~2=5.759、5.831,P<0.05)。结论临床治疗凶险性前置胎盘合并胎盘植入中,在剖宫产术开展腹主动脉球囊导管预置术具有较好效果,值得临床推广应用。

Objective This paper tries to summarize the value of abdominal aortic balloon occlusion in the treatment of cesarean section with malignant placenta previa combined with placenta implantation. Methods Collected in March 2015 to December 2017 of 70 cases of placenta previa merged dangerous sex placenta implantation in patients with clinical data, the principle of digital meter random was used to divide into two groups, 35 cases in the control group cases in cesarean section, and did not receive preoperative abdominal aortic balloon catheter preset observation group receive abdominal aortic balloon catheter in cesarean delivery preoperative preset, compare two groups of operation con- dition （including operation time, intraoperative blood loss）, and maternal and neonatal outcome. Results The operative time （63.79±4.30） rain and intraoperative blood loss （920.56±197.58）mL of the obset＇vation group were significantly low er than those of the control group （91.79 ±8.25） rain and （2 789.52 ± 331.52）mL, and the difference was statistically sig- nificant （t=17.805, -28.650, P〈0.05）. The uterine clearance rate 8.57% and icu transfer rate 11.43% in the question- naire observation group were significantly lower than the control group 22.86% and 25.71%, and the difference was sta- tistically significant （χ2=5.759,5.831,P〈0.05）. Conclusion In the clinical treatment of malignant placenta previa com- bined with placenta implantation, abdominal aortic balloon catheterization is effective in caesarean section, which is worthy of clinical application.