顺应性腹主动脉球囊阻断术在凶险性前置胎盘患者剖宫产中应用效果

Application of compliant abdominal aortic balloon occlusion in cesarean section of patients with pernicious placenta previa

目的探讨顺应性球囊腹主动脉阻断术用于凶险性前置胎盘患者剖宫产的效果。方法选取2017年6月~2020年3月来我院产科行剖宫产分娩、患有凶险性前置胎盘的待产孕妇患者58例。将前期收治的29例患者作为A组,剖宫产术前以球囊扩张导管行非顺应性腹主动脉球囊阻断术(术前腹主动脉球囊预置、术中暂时阻断腹主动脉血流);将后期收治的29例患者作为B组,剖宫产术前以双腔取血栓导管行顺应性腹主动脉球囊阻断术。比较两组患者所用球囊规格、介入治疗时间、辐射剂量、术中出血量、并发症、球囊阻断成功率等。结果B组手术时间短于A组、并发症发生率少于A组,差异有统计学意义(P<0.05);在孕妇辐射剂量、球囊阻断成功率、剖宫产术中出血量等方面差异无统计学意义(P>0.05)。结论顺应性球囊腹主动脉阻断术用于凶险性前置胎盘患者剖宫产可缩短手术时间,降低了手术风险,更好地保障母婴安全。

Objective To evaluate the effect of compliance balloon abdominal aortic occlusion on cesarean section in patients with pernicious placenta previa.Methods 58 pregnant women with pernicious placenta previa were selected from June 2017 to March 2020.29 patients in the early stage were selected as group A,and the non-compliant abdominal aortic balloon occlusion(preoperative abdominal aortic balloon preset and intra-operative temporary occlusion of abdominal aortic blood flow)were performed before cesarean section;29 patients in the late stage were selected as group B,and the compliance abdominal active vein balloon occlusion was performed before cesarean section.The balloon size,interventional operation time,radiation dose,intra-operative blood loss,complications and success rate of balloon occlusion were compared between the two groups.Results The operation time of group B was shorter than that of group A,the incidence of complications was less than that of group A,the difference was statistically significant(P<0.05).There was no significant difference in radiation dose of pregnant women,blood loss during cesarean section,success rate of balloon occlusion(P>0.05).Conclusion Compliance balloon abdominal aortic occlusion in patients with pernicious placenta previa can shorten the operation time,reduce the risk of operation,which is more conducive to the safety of mother and baby.