双髂内动脉球囊闭塞术在凶险型前置胎盘剖宫产中的临床效果分析

Analysis of Clinical Effect of Double Internal Iliac Artery Balloon Occlusion in Pernicious Placenta Previa Cesarean Section

目的探讨在凶险型前置胎盘剖宫产中应用双髂内动脉球囊闭塞术的临床效果。方法选取2012年4月至2014年6月成都市妇女儿童中心医院收治的凶险型前置胎盘孕妇82例为研究对象,依据随机数字表法分为对照组和观察组,各41例。对照组接受常规剖宫产术治疗,观察组在剖宫产中应用双髂内动脉球囊闭塞术,观察两组孕妇手术及住院情况,手术前后血红蛋白(Hb)水平,并发症发生情况及新生儿情况。结果观察组手术时间及术后住院时间显著短于对照组[(75±12)min比(132±23)min,(6.4±1.5)d比(9.8±1.7)d,P<0.01],术中出血量显著少于对照组[(1439±326)m L比(3219±438)m L](P<0.01);两组孕妇术前Hb水平差异无统计学意义(P>0.05),术后均明显低于术前,观察组术后Hb水平高于对照组[(90±12)g/L比(85±11)g/L](P<0.05);观察组并发症发生率显著低于对照组[9.76%(4/41)比26.83%(11/41)],差异有统计学意义(P<0.05);两组新生儿体质量差异无统计学意义(P>0.05),观察组新生儿Apgar评分显著高于对照组[(8.6±0.7)分比(7.8±0.5)分,P<0.05]。结论对于凶险型前置胎盘孕妇,在剖宫产中应用双髂内动脉球囊闭塞术,能有效缩短手术时间,减少术中出血量,并能有效预防并发症,改善预后,具有较高临床应用价值。

Objective To investigate the clinical effect of double internal iliac artery balloon occlusion in pernicious placenta previa cesarean section. Methods Total of 82 cases ofpernicious placenta previa in Chengdu Women & Children' s Central Hospital from Apr. 2012 to Jun. 2014 were divided into a control group and an observation group according to the random number table method,41 cases in each group. The control group was given routine cesarean section; the observation group was given bilateral internal iliac artery balloon during cesarean section. The operationsituation and hospital stay,preoperative and postoperative Hb level,complication and neonatal condition of the two groups were observed. Results Operation time and postoperative hospitalization time of the observation group were shorter than control group[( 75 ± 12) min vs( 132 ± 23) min,( 6. 4 ± 1. 5) d vs( 9. 8 ± 1. 7) d,P < 0. 01]; blood loss of the observation group was less than the control group[( 1439 ± 326) m L vs( 3219 ± 438) m L]( P < 0. 01); the preoperative Hb levels of the two groups had no significant difference( P > 0. 05),the postoperative Hb level was significantly lower than the preoperative level,and the observation group was higher than the control group[( 90 ± 12) g / L vs( 85 ± 11) g/L]( P < 0. 05); the complication incidence of the observation group was significantly lower than the control group[9. 76%( 4 /41) vs 26. 83%( 11 /41) ]( P < 0. 05); the neonatal body mass had no statistically significant difference( P > 0. 05),the neonatal Apgar score of the observation group was significantly higher than the control group[( 8. 6 ± 0. 7) scores vs( 7. 8 ± 0. 5) scores,P < 0. 05]. Conclusion For the pernicious placenta previa patients,the application of bilateral internal iliac artery balloon occlusion in cesarean section can effectively shorten the operation time,reduce intraoperative bleeding,and prevent complications,which improves the prognosis,and has high clinical application value.