球囊暂时阻断腹主动脉下段预防完全性前置胎盘产后出血的效果探讨

The Effect of Temporary Block of the Lower Part of Abdominal Aorta by Balloon on Prevention of Complete Placenta Previa Postpartum Hemorrhage

目的探讨球囊暂时阻断腹主动脉下段预防完全性前置胎盘产后出血的临床效果。方法将我院2018年5月至2020年5月间收治的62例完全性前置胎盘患者作为研究对象,根据治疗方案的不同分为研究组(n=31)以及对照组(n=31)。对照组进行单纯剖宫产,研究组以球囊暂时阻断腹主动脉下段,再进行剖宫产,对比两组患者产后出血发生率、术中输血量、术中出血量以及术后24h总出血量。另外,比较两组患者住院时间以及子宫切除率。结果研究组产后出血发生率(9.68%)要明显低于对照组(32.26%)(c2=4.769,P=0.029)。研究组术中出血量要低于对照组(t=4.224,P=0.001);研究组术后24h总出血量要低于对照组(t=4.908,P=0.001)。研究组住院时间为(5.67±1.82)d,对照组住院时间为(7.43±1.95)d,研究组住院时间要短于对照组(t=3.674,P=0.001)。研究组子宫切除率为3.23%,对照组为19.35%,研究组子宫切除率要低于对照组(c2=4.026,P=0.045)。结论球囊暂时阻断腹主动脉下段在能够有效预防完全性前置胎盘产后出血,降低产后出血发生率。

Objective To investigate the clinical effect of temporary block of the lower segment of abdominal aorta by balloon in preventing complete placenta previa postpartum hemorrhage.Methods 62 patients with complete placenta previa admitted in our hospital from May 2018 to May 2020 were divided into study group (n=31) and control group (n=31) according to different treatment plans.The control group underwent simple cesarean section,while the study group temporarily blocked the lower segment of abdominal aorta with balloon,and then underwent cesarean section.The incidence of postpartum hemorrhage,the amount of intraoperative blood transfusion volume,intraoperative hemorrhage and the total amount of bleeding 24 hours after operation were compared between the two groups.In addition,the hospitalization time and hysterectomy rate of the two groups were compared.Results The incidence of postpartum hemorrhage in the study group (9.68%) was significantly lower than that in the control group (32.26%) (c2=4.769,P=0.029).The blood transfusion volume in the study group was lower than that in the control group (t=5.526,P=0.001).The amount of intraoperative hemorrhage in the study group was lower than that in the control group (t=4.224,P=0.001).The total amount of bleeding in the study group was lower than that in the control group (t=4.908,P=0.001).The hospitalization time of the study group was (5.67±1.82) d,and that of the control group was (7.43±1.95) d,the hospitalization time of the study group was shorter than that of the control group (t=3.674,P=0.001).The hysterectomy rate of the study group was 3.23%,and that of the control group was 19.35%,the hysterectomy rate of the study group was lower than that of the control group (c2=4.026,P=0.045).Conclusion Temporary block of the lower segment of the abdominal aorta by balloon can effectively prevent complete placenta previa postpartum hemorrhage,reduce the incidence of postpartum hemorrhage,and provide safety for patients.