不同性质球囊腹主动脉阻断术在凶险性前置胎盘应用中的对比研究

The application of abdominal aortic occlusion using balloon of different properties in treating dangerous placenta previa:a comparative study

目的 对比不同球囊腹主动脉阻断术治疗凶险性前置胎盘的效果.方法 回顾性分析2018年2月至2021年5月遵义医科大学第二附属医院收治的102例凶险性前置胎盘患者临床资料.52例接受非顺应性球囊腹主动脉阻断术(研究组),50例接受顺应性球囊腹主动脉阻断术(对照组).观察两组腹主动脉球囊阻断术实施情况.记录两组患者腹主动脉阻断术前后血压、心率变化.统计两组球囊阻断时间、X射线辐射,剖宫产手术及术后并发症情况.结果 两组均成功置入球囊,腹主动脉阻断术成功,无死亡病例.两组腹主动脉球囊阻断术前后患者心率、收缩压差异无统计学意义(均P>0.05).两组X线辐射剂量、胎儿射线暴露时间差异无统计学意义(均P>0.05),研究组球囊阻断时间低于对照组(P<0.05).研究组剖宫产术中出血量低于对照组(P<0.05),两组输血率、红细胞输注量、子宫切除率差异无统计学意义(均P>0.05).两组腹主动脉球囊阻断术相关并发症发生率差异无统计学意义(P>0.05).结论 顺应性和非顺应性球囊腹主动脉球囊阻断术治疗凶险性前置胎盘均安全有效,但使用非顺应性球囊在减少剖宫产术中出血量方面更具优势.

Objective To compare the curative effect of different types of balloon in performing abdominal aortic occlusion for the treatment of dangerous placenta previa.Methods The clinical data of 102 patients with dangerous placenta previa,who were admitted to the Second Affiliated Hospital of Zunyi Medical University of China to receive treatment between February 2018 and May 2021,were retrospectively analyzed.Of the 102 patients,52 received non-compliant balloon abdominal aortic occlusion(study group)and 50 received compliant balloon abdominal aortic occlusion(control group).The implementation of the abdominal aortic balloon occlusion procedures in the two groups was assessed.Before and after abdominal aortic occlusion,the blood pressure and heart rate in both groups were recorded.The duration of abdominal aortic balloon occlusion,Xray radiation,the amount of blood loss during cesarean section and postoperative complications in the two groups were calculated.Results Successful abdominal aortic occlusion by using balloon implantation was accomplished in all patients of both groups.No death occurred.In both groups,the postoperative heart rate and systolic blood pressure were not significant different from the preoperative ones(all P>0.05).No statistically significant differences in X-ray radiation dose and fetal radiation exposure time existed between the two groups(all P>0.05).The duration of abdominal aortic balloon occlusion in the study group was obviously shorter than that in the control group(P<0.05).The amount of blood loss during cesarean section in the study group was remarkably less than that in the control group(P<0.05).There were no statistically significant differences in blood transfusion rate,red blood cell transfusion volume and hysterectomy rate between the two groups(all P>0.05).No statistically significant difference in the incidence of procedure-related complications existed between the two groups(P>0.05).Conclusion In treating dangerous placenta previa,abdominal aortic balloon occlusion,regardless of using compliant balloon or using non-compliant balloon,is clinically safe and effective,but the use of non-compliant balloon is superior to the use of compliant balloon in reducing the amount of blood loss during cesarean section.