腹主动脉球囊阻断术治疗凶险型前置胎盘伴胎盘植入的临床观察

Clinical Observation of Intra-aortic Abdominal Aorta Balloon Occlusion for Pernicious Placenta Previa Complicated with Placenta Implantation

目的探讨腹主动脉球囊导管阻断术在凶险型前置胎盘合并胎盘植入患者剖宫产中的临床应用效果。方法回顾性分析本院2017年1月~2018年6月期间住院治疗的凶险型前置胎盘合并胎盘植入患者,共有140例患者入院分娩,118例患者剖宫产术中应用腹主动脉球囊阻断术,为IAABO组;22例患者行常规剖宫产术,为常规组。分析比较两组患者术中出血量、输血量、子宫切除率、术后相关并发症及住院时间,随访患者术后恶露持续时间及月经复潮情况,并对上述因素归纳、分析、总结。结果 IAABO组术中出血量、输血量较常规组患者减少(P <0.05),IAABO组子宫切除率低于常规组(P <0. 05)。IAABO组与常规组孕妇住院时间、术后并发症发生率、恶露持续时间及月经复潮比较无统计学差异(P> 0.05)。结论在凶险型前置胎盘合并胎盘植入患者剖宫产术中应用腹主动脉球囊阻断术,可有效降低术中出血量、输血量及子宫切除率,且不影响子宫复旧,相关介入并发症发生率较低,建议在严格掌握适应症的情况下进行临床应用。

Objective To explore the clinical effect of intra-aortic abdominal aorta balloon occlusion in cesarean section for patients with pernicious placenta previa complicated with placenta implantation. Methods A total of 140 delivery patients with pernicious placenta previa complicated with placenta implantation in the Third Affiliated Hospital of Zhengzhou University during the period from January 2017 to June 2018 was retrospectively analyzed.They were divided into 2 groups.118 patients accepted Intra-aortic abdominal aorta balloon occlusion during cesarean section,which was IAABO group;22 patients underwent routine cesarean section, which was the routine group. The blood volume, transfusion volume, hysterectomy rate, postoperative complications and hospitalization time were analyzed and compared between the two groups. The duration of lochia and menstrual reactivation were followed up,and the factors mentioned above were analyzed and summarized. Results The intraoperative blood loss and transfusion volume in IAABO group were lower than those in routine group (P < 0.05), and the hysterectomy rate in IAABO group was lower than that in routine group (P < 0.05). There was no significant difference in hospitalization time,incidence of complications,duration of lochia and menstruation recovery between IAABO group and routine group (P > 0.05). Conclusion The application of intra-aortic abdominal aorta balloon occlusion in caesarean section for patients with pernicious placenta previa complicated with placenta implantation can reduce the amount of bleeding, blood transfusion and hysterectomy rate, without affecting uterine involution, and the incidence of related interventional complications is low. It is worth popularizing under the condition of strict control of indications.