腹主动脉球囊预置阻断术预防重度胎盘植入患者剖宫产产后出血的价值

Value of abdominal aortic balloon occlusion in the prevention of postpartum hemorrhage after cesarean delivery in patients with severe placental implantation

目的探讨腹主动脉球囊预置阻断术预防重度胎盘植入患者剖宫产产后出血的价值。方法选取2018年1月至2021年11月海南医学院第二附属医院收治的160例重度胎盘植入患者为研究对象,随机分为观察组和对照组各80例。对照组采用常规剖宫产止血,观察组采用腹主动脉球囊预置阻断术,观察比较两组患者手术指标、产后出血率、子宫切除率、血红蛋白、新生儿情况及术后并发症。结果观察组患者手术时间、术中出血量、术中输血量均低于对照组,差异有统计学意义(t值分别为6.071、7.656、32.160,P<0.05);观察组患者产后出血率、子宫切除率低于对照组,差异有统计学意义(χ^(2)值分别为19.259、5.331,P<0.05);术后24h,观察组患者血红蛋白高于对照组,差异有统计学意义(t=4.088,P<0.05);两组患者术后并发症、新生儿1 minApgar评分、出生体重比较,差异均无统计学意义(P>0.05)。结论腹主动脉球囊预置阻断术预防重度胎盘植入患者剖宫产产后出血的价值较好,能有效缩短手术时间,减少术中出血量、输血量和术后血红蛋白下降率,降低产后出血率及子宫切除率。

Objective To explore the value of abdominal aortic balloon occlusion in the prevention of postpartum hemorrhage after cesarean delivery in patients with severe placental implantation.Methods A total of 160 patients with severe placental implantation admitted to the Second Affiliated Hospital of Hainan Medical University from January 2018 to November 2021 were selected as the research subjects,and randomly divided into the observation group and the control group,with 80 patients in each group.The control group was treated with routine hemostasis for cesarean section,and the observation group was treated with abdominal aortic balloon preset occlusion.The surgical indicators,postpartum hemorrhage rate,hysterectomy rate,hemoglobin,neonatal situation and postoperative complications of the two groups were observed and compared.Results The operation time,intraoperative blood loss and intraoperative blood transfusion in observation group were lower than those in control group,the differences were statistically significant(t values were 6.071,7.656 and 32.160,respectively,P<0.05).The postpartum hemorrhage rate and hysterectomy rate in the observation group were lower than those in the control group,and the differences were statistically significant(χ^(2)were 19.259 and 5.331,respectively,P<0.05).24 h after surgery,hemoglobin in observation group was higher than that in control group,the difference was statistically significant(t=4.088,P<0.05).There were no significant differences in postoperative complications,1-min Apgar score and birth weight between two groups(P>0.05).Conclusion The value of abdominal aortic balloon occlusion to prevent postpartum hemorrhage after cesarean delivery in patients with severe placental implantation is good,which can effectively shorten the operation time,reduce intraoperative bleeding,intraoperative blood transfusion and postoperative hemoglobin decline rate,and reduce the rate of postpartum hemorrhage and hysterectomy.