腹主动脉球囊阻断联合子宫动脉栓塞在高危前置胎盘剖宫产术中的应用

Analysis of the effect of abdominal aortic balloon occlusion combined with uterine artery embolization on high-risk placenta previa cesarean section

目的:探讨腹主动脉球囊阻断联合子宫动脉栓塞在高危前置胎盘剖宫产术中应用的效果。方法:采用前瞻性研究方法,纳入2016年12月至2019年12月新疆克拉玛依市中心医院就诊的49例高危前置胎盘患者,根据患者意愿分配入腹主动脉球囊阻断联合子宫动脉栓塞组(研究组)27例,传统剖宫产手术组(对照组)22例。对比两组术中出血量、红细胞输注量、血浆输注量、手术时间、住院天数、住院费用、子宫切除率以及术后并发症发生情况。结果:研究组术中出血量为(802.2±207.9)ml,红细胞输注量为(407.4±263.0)ml,血浆输注量为(348.1±180.5)ml,手术时间为(119.8±16.6)min,住院天数为(7.1±2.1)d,住院费用为(30393.7±4526.5)元。对照组术中出血量为(1390.9±315.3)ml,红细胞输注量为(1181.8±469.7)ml,血浆输注量为(745.5±238.5)ml,手术时间为(101.4±12.9)min,住院天数为(12.3±2.0)d,住院费用为(10201.9±1037.7)元。研究组在减少术中出血量、红细胞输注量、血浆输注量方面更有优势,两组比较差异有统计学意义(P均<0.05),但是手术时间及住院费方面明显高于对照组,两组比较差异有统计学意义(P均<0.05)。对照组4例行子宫全切除术,两组差异有统计学意义(P=0.035)。研究组发生1例下肢动脉血栓形成,对照组未发生并发症。所有患者均获得随访,研究组和对照组患者均无闭经,但有不同程度的月经不规律和月经量的变化。结论:腹主动脉球囊阻断联合子宫动脉栓塞在高危前置胎盘剖宫产术中应用是安全、有效的,有利于保留子宫。

Objective To investigate the effect of abdominal aortic balloon occlusion combined with uterine artery embolization in high-risk placenta previa cesarean section.Methods Forty-nine high-risk patients with placenta previa admitted to Xinjiang Karamay Central Hospital from December 2016 to December 2019 were prospectively included.According to the patients'intention,they were assigned to the abdominal aortic balloon occlusion combined with uterine artery embolization group(research group,27 cases)or the traditional cesarean section group(control group,22 cases).The intraoperative blood loss,erythrocyte infusion,plasma infusion,operation time,hospital stay,hospitalization expenses,hysterectomy rate and postoperative complications were compared between the two groups.Results In the research group,intraoperative blood loss,erythrocyte infusion,plasma infusion,operation time,hospitalization days,and hospitalization cost was(802.2±207.9)ml,(407.4±263.0)ml,(348.1±180.5)ml,(119.8±16.6)min,(7.1±2.1)days and(30393.7±4526.5)yuan,respectively.In the control group,intraoperative blood loss erythrocyte infusion,plasma infusion,operation time,hospitalization days,and hospitalization cost was(1390.9±315.3)ml,(1181.8±469.7)ml,(745.5±238.5)ml,(101.4±12.9)min,(12.3±2.0)days and(10201.9±1037.7)yuan,respectively.Research group had more advantages in reducing intraoperative blood loss,erythrocyte infusion and plasma infusion,and the differences between the two groups was statistically significant(all P<0.05).However,there was no significant advantage in operation time and hospitalization expenses,and the difference between the two groups was statistically significant(all P<0.05).Hysterectomy was performed on 4 cases in control group,and the difference was statistically significant(P=0.035).One case of lower limb arterial thrombosis complication occurred in the research group,while no complication occurred in the control group.Conclusion Abdominal aortic balloon occlusion combined with uterine artery embolization is safe and effective in high-risk placenta previa cesarean section,which is beneficial to the preservation of uterus.