腹主动脉球囊阻断术在腹腔及盆腔手术中的应用效果及安全性研究

Effect and safety of abdominal aortic balloon occlusion in abdominal and pelvic surgery

目的:探讨腹主动脉球囊阻断术在腹腔及盆腔手术中的应用效果及安全性。方法:选择近年来在韶关市第一人民医院进行腹腔及盆腔手术的67例患者(其中复杂性髋臼骨折、骨盆恶性肿瘤、凶险性前置胎盘患者分别有43例、11例、13例)作为研究对象。进行腹腔及盆腔手术时,均采用腹主动脉球囊阻断术为这些患者止血,然后观察其各项临床指标。结果:67例患者手术的时间、术中的出血量和输血量均控制较好,其术后住院的时间较短。在67例患者中,复杂性髋臼骨折患者治疗的优良率为93.0%;骨盆恶性肿瘤患者术后半年内、1年内及2年内病情的复发率分别为9.1%、18.2%和36.4%;凶险性前置胎盘患者子宫的切除率为0.0%,其新生儿的平均体重为(3.2±0.3)kg,其新生儿出生后1 min平均的新生儿Apgar评分为(8.1±1.2)分。67例患者术后并发症的发生率为10.4%。结论:腹主动脉球囊阻断术在腹腔及盆腔手术(包括复杂性髋臼骨折手术、骨盆恶性肿瘤手术、凶险性前置胎盘手术等)中的应用效果显著,能有效控制术中出血,提高手术的效果,减少患者术后的并发症。

Objective:To investigate the efficacy and safety of abdominal aortic balloon occlusion in abdominal and pelvic surgery.Methods:Sixty-seven patients who underwent abdominal and pelvic surgery in shaoguan First People’s Hospital in recent years(43 patients with complex acetabular fracture,11 patients with pelvic malignant tumor and 13 patients with dangerous placenta previa,respectively)were selected as the research objects.During abdominal and pelvic surgery,abdominal aortic balloon occlusion was used to stop bleeding in these patients,and clinical indicators were observed.Results:The operation time,blood loss and blood transfusion volume of 67 patients were well controlled,and the postoperative hospitalization time was shorter.In 67 patients,the excellent and good rate of complex acetabular fractures was 93.0%.The recurrence rates of pelvic malignancy within six months,one year and two years were 9.1%,18.2%and 36.4%,respectively.The average neonatal weight was(3.2±0.3)kg,and the Apgar score was(8.1±1.2)points 1 min after birth.The incidence of postoperative complications in 67 patients was 10.4%.Conclusion:Abdominal aortic balloon occlusion is effective in abdominal and pelvic surgery(including complex acetabular fracture surgery,pelvic malignant tumor surgery,dangerous placenta previa surgery,etc.),which can effectively control intraoperative bleeding,improve the surgic al effect and reduce postoperative complications.