腹主动脉球囊扩张术治疗凶险性前置胎盘疗效观察

Clinical effect of temporary balloon dilation of abdominal aorta in treatment of dangerous placenta previa

目的探讨腹主动脉球囊扩张术治疗凶险性前置胎盘的临床效果。方法回顾性分析2015年10月至2017年10月濮阳市油田总医院产科收治的57例凶险性前置胎盘患者的临床资料,其中剖宫产术前行腹主动脉球囊扩张术患者31例(观察组),行常规剖宫产术26例(对照组)。比较2组患者术中出血量、输血量、弥散性血管内凝血(DIC)发生率、子宫切除率及新生儿情况。结果观察组患者术中出血量和输血量低于对照组(t=12.320、7.450,P<0.05)。对照组患者DIC发生率和子宫切除率分别为23.08%(6/26)和30.77%(8/26),观察组患者DIC发生率和子宫切除率分别为3.23%(1/31)和3.23%(1/31),观察组患者DIC发生率及子宫切除率低于对照组(χ~2=2.511、3.377,P<0.05)。观察组与对照组新生儿体质量和窒息率比较差异无统计学意义(t=1.762,χ~2=0.571; P>0.05)。结论剖宫产术前行腹主动脉球囊扩张术能够有效减少患者的出血量和输血量,降低子宫切除率。

Objective To investigate the clinical effect of abdominal aortic preset balloon dilation in treating patients with dangerous placenta previa undergoing cesarean section. Methods The clinical data of57 patients with dangerous placenta previa who were admitted to Puyang Oilfield General Hospital from October2015 to October2017 were analyzed retrospectively.Among the57 patients,31 cases were given abdominal aortic balloon dilation before cesarean section (observation group) and26 cases were given cesarean section (control group).The amount of intraoperative blood loss, volume of blood transfusion,rates of disseminated intravascular coagulation (DIC) and hysterectomy,prognosis of infants were observed and compared between the two groups. Results The amount of intraoperative blood loss and volume of blood transfusion of patients in observation group were significantly decreased compared with the control group ( t =12.320,7.450;P < 0.05).The rates of DIC and hysterectomy in the control group were23.08%(6/26) and30.77%(8/26),respectively.And they were3.23%(1/31) and3.23%(1/31) in the observation group,respectively.The rates of DIC and hysterectomy in the observation group were significantly lower than those in the control group (χ^2=2.511,3.377;P <0.05).There was no significant difference in neonatal body mass and asphyxia rate between the observation group and the control group ( t =1.762,χ^2=0.571;P >0.05). Conclusion Temporary balloon dilation of the distal abdominal aorta before performing cesarean section can decrease the intraoperative blood loss,blood transfusion,and the rate of hysterectomy.