不同位置动脉球囊阻断在凶险性前置胎盘术中的应用价值
Application value of arterial balloon occlusion at different sites during pernicious placenta previa surgery
张剑 1陈蕾蕾 1黄士勇 1胡文豪1
作者信息
- 1. 325000 温州,温州医科大学附属第一医院
- 折叠
摘要
目的 评估不同位置动脉球囊阻断术在凶险性前置胎盘合并胎盘植入剖腹产术中应用临床效果及安全性的对比研究.方法 本院 2015 年 9 月至 2022 年 8 月共有 57 例经多普勒超声和/或核磁共振证实凶险性前置胎盘合并胎盘植入,在剖腹产术前行动脉球囊阻断术,其中腹主动脉球囊阻断术(A组)26 例,髂总动脉球囊阻断术(B组)31 例.结果 A、B两组合计子宫保有率 100%(57/57),剖宫产手术时间、新生儿Apgar评分(1 min、5 min)两组之间差异无统计学意义(P＞0.05),A组术中出血量显著低于B两组术中出血量(P＜0.05),放射防护安全性方面,A组明显优于B组(P＜0.05).A组分别出现 1例球囊回撤失败,B组分别出现 1例动脉血栓和 1例下肢静脉血栓,两组之间差异无统计学意义(P＞0.05).结论 腹主动脉球囊阻断术和髂总动脉球囊阻断术均可降低子宫切除率,保留患者生育功能,但是腹主动脉球囊阻断术中出血量及放射防护安全性均优于髂总动脉球囊阻断术.
Abstract
Objective To evaluate the clinical efficacy and safety of balloon occlusion at different sites in the caesarean section of pernicious placenta previa combined with placenta accreta.Methods From September 2015 to August 2022,57 patients were with pernicious placenta previa combined with placenta accreta diagnosed by ultrasound and/or magnetic resonance imaging were submitted to prophylactic temporary balloon occlu-sion before caesarean section,including 26 cases of abdominal aortic balloon occlusion(Group A)and 31 cases of common iliac artery balloon occlu-sion(Group B).Results The uterine retention rate of group A and group B was 100%(57/57),no statistically significant differences in the time spent for cesarean section and in neonatal Apgar score(measured at 1 min,5 min and 10 min)existed between the two groups(P＞0.05).The intraop-erative blood loss in group A was significantly lower than that in group B(P＜0.05).And in terms of radiation protection safety,group A was signifi-cantly better than group B(P＜0.05).There was one case of balloon withdrawal failure in group A,one case of arterial thrombosis and one case of ve-nous thrombosis of the lower extremity in group B,and all of them were successfully resolved after active treatment.Conclusion Abdominal aortic balloon occlusion and common iliac artery balloon occlusion can reduce the hysterectomy rate and preserve the reproductive function of patients,but the blocking effect,intraoperative blood loss and radiation protection safety of abdominal aortic balloon occlusion are better than those of common iliac artery balloon occlusion.
关键词
凶险性前置胎盘/胎盘植入/球囊阻断术Key words
Pernicious placenta previa/Placenta implantation/Balloon occlusion引用本文复制引用
基金项目
浙江省温州市基础性科研项目(Y2020507)
出版年
2024
NETL
NSTL
万方数据