经皮股动脉穿刺动脉造影下腹主动脉球囊血流临时性阻断技术规范中国专家共识

Chinese expert consensus on the technical specification for temporary balloon occlusion of abdominal aorta blood flow under the guidance of aortic angiography via femoral artery access

胎盘植入患者行剖宫产术及骨盆/骶骨肿瘤患者行切除手术都存在术中大出血的风险,严重情况下甚至危及患者生命,如何减少术中出血量是临床医生面临的重大问题。随着介入放射学的发展,经皮股动脉穿刺动脉造影下腹主动脉球囊血流临时性阻断技术在此类疾病中得到广泛应用,此技术在术中能有效减少子宫、胎盘、骨盆及骶骨肿瘤的血液灌注量,由此减少术中出血量及输血量,提高了手术的安全性。但是目前关于腹主动脉球囊阻断技术应用中的相关技术要点如球囊放置位置、术中阻断时长等尚无统一认识。本共识由国内放射介入科、产科及骨科等专家共同制定,聚焦于适应证的选择、术中操作细节把控及围手术期相关并发症的处理等关键点,旨在提高胎盘植入、骨盆及骶骨肿瘤切除等高风险手术的成功率,降低相关并发症的发生率。

Patients with placental implantation who are undergoing cesarean section,and patients with pelvic/sacral tumors who are undergoing surgical resection are at risks of intraoperative massive bleeding,and severe bleeding can even endanger the life of the patients.How to reduce the amount of intraoperative blood loss is a major issue facing clinicians.With the development of interventional radiology,the temporary balloon occlusion of abdominal aorta under the guidance of aortic angiography via femoral artery access has been widely used in the treatment of these diseases.As it can effectively reduce the amount of blood perfusion of uterine,placenta,pelvic and sacral tumors,this technique can reduce the amount of intraoperative blood loss and blood transfusion,and improve the safety of the surgery.However,at present there is no unified understanding of the relevant technical points of temporary balloon occlusion of abdominal aorta technology,such as balloon placement location,intraoperative balloon occlusion duration,etc.This consensus is jointly writen by domestic experts who are involved in interventional radiology,obstetrics and orthopedics,focusing on the key points such as the selection of indications,control of intraoperative operation details,management of perioperative complications,aiming to improve the success rate of high-risk surgeries for patients with placental implantation or pelvic/sacral tumors and reduce the incidence of procedure-related complications.