腹主动脉与双侧髂内动脉球囊阻断术对胎盘植入剖宫产产后出血的预防效果比较

Comparison of effects of balloon occlusion of abdominal aorta and internal iliac artery in prevention of postpartum hemorrhage of patients with cesarean section and placenta implantation

目的:比较腹主动脉与双侧髂内动脉球囊阻断术对胎盘植入剖宫产产后出血的预防效果。方法:回顾性分析2018年12月至2021年12月该院收治的105例胎盘植入剖宫产产妇的临床资料,根据球囊阻断术方法不同分为对照组52例与观察组53例。对照组行双侧髂内动脉球囊阻断术,观察组行腹主动脉球囊阻断术。比较两组球囊阻断手术时间、剖宫产术中和术后2 h出血量,胎儿受到辐射剂量、术后并发症发生率及新生儿窒息情况。结果:观察组球囊阻断手术时间短于对照组,术中、术后2 h出血量及胎儿受到辐射剂量均少于对照组,差异有统计学意义(P<0.05);两组术后并发症发生率及新生儿出生1、5 min Apgar评分比较,差异均无统计学意义(P>0.05)。结论:与双侧髂内动脉球囊阻断术相比,采用腹主动脉球囊阻断术预防胎盘植入剖宫产产后出血效果更好,手术时间较短,可减少术中、术后出血量和胎儿受到辐射剂量,不会增加并发症和新生儿窒息发生风险。

Objective:To compare effects of balloon occlusion of abdominal aorta and internal iliac artery in prevention of postpartum hemorrhage of patients with cesarean section and placenta implantation.Methods:The clinical data of 105 pregnant women with placenta implantation and cesarean section admitted to the hospital from December 2018 to December 2021 were retrospectively analyzed.According to different balloon occlusion methods,they were divided into control group(52 cases)and observation group(53 cases).The control group underwent bilateral internal iliac artery balloon occlusion,while the observation group underwent abdominal aortic balloon occlusion.The operation time of balloon occlusion,the intraoperative blood loss during cesarean section and 2 h at the postoperative,the fetal radiation dose,and the incidence of postoperative complications and neonatal asphyxia were compared between the two groups.Results:The operation time of balloon occlusion in the observation group was shorter than that in the control group;the intraoperative blood loss,the postoperative 2 h blood loss and the fetal radiation dose were less than those in the control group;and the differences were statistically significant(P<0.05).However,there were no significant differences in the incidence of postoperative complications and the Apgar scores at 1 min and 5 min after birth between the two groups(P>0.05).Conclusions:Compared with bilateral internal iliac artery balloon occlusion,abdominal aortic balloon occlusion is more effective in the prevention of postpartum hemorrhage of the patients with cesarean section and placenta implantation with shorter operation time,less intraoperative and postoperative blood loss and fetal radiation dose,and no increase in the incidence of complications and neonatal asphyxia.