本文選題：兇險(xiǎn)型前置胎盤　切入點(diǎn)：胎盤植入　出處：《南京醫(yī)科大學(xué)學(xué)報(bào)(自然科學(xué)版)》2017年11期 　論文類型：期刊論文

【摘要】：目的:探討剖宮產(chǎn)術(shù)中腹主動(dòng)脈球囊阻斷術(shù)聯(lián)合子宮胎盤植入部位切除及修補(bǔ)術(shù)的療效。方法 :回顧性分析2016年9—12月南京某院收治的12例兇險(xiǎn)型前置胎盤伴胎盤植入患者的手術(shù)方式及處理流程。結(jié)果:12例術(shù)中出血600~4 000 m L,術(shù)中平均失血(2 325.00±1 453.81)m L。輸注紅細(xì)胞懸液0~15 U,平均(7.38±5.13)U。輸注血漿0~1 000 m L,平均(518.75±304.65)m L。產(chǎn)后24 h出血量670~4 230 m L,平均出血量(2 413.75±1 460.50)m L。所有患者均未發(fā)生彌散性血管內(nèi)凝血,無穿刺部位血腫形成。術(shù)后1周下肢動(dòng)脈B超未見明顯異常,術(shù)后1周血人絨毛膜促性腺激素13.71~5 382.00 m U/m L,平均(797.68±1 532.07)m U/m L。新生兒出生體重1 500~3 600g,平均(2 556.25±660.86)g,50%新生兒因低體重、呼吸窘迫綜合征等原因轉(zhuǎn)兒科治療。出生后1個(gè)月隨訪新生兒發(fā)育無明顯異常。結(jié)論:剖宮產(chǎn)術(shù)中腹主動(dòng)脈球囊阻斷術(shù)聯(lián)合子宮胎盤植入部位切除及修補(bǔ)術(shù)能有效減少術(shù)中出血,降低子宮切除率,是一種安全、有效、可施行的綜合治療新方法。
[Abstract]:Objective: to investigate the effect of abdominal aortic balloon occlusion combined with placenta accreta resection and repair during cesarean section. Methods: a retrospective analysis of 12 cases of dangerous placenta previa with fetus in Nanjing from September to December, 2016 was carried out. Results 12 cases with intraoperative bleeding of 600,000ml and an average of 2 325.00 鹵1 453.81mL during operation were treated with disc implantation. The erythrocyte suspension was injected with 0.15 U, mean 7.38 鹵5.13 渭. Plasma was injected with plasma 0.000 mL (mean 518.75 鹵304.65 min / L). The volume of blood loss at 24 hours postpartum was 670m / 4. 230ml, the mean bleeding volume was 2413.75 鹵1 460.50ml. No disseminated intravascular coagulation was found in all the patients. There was no hematoma formation at the puncture site. There was no obvious abnormality in B-mode ultrasound of lower extremity artery 1 week after operation. At 1 week after operation, the serum human chorionic gonadotropin (HHCG) was 13.71 ~ 5382.00 m / m / m L, with an average of 797.68 鹵1 532.07 m / m ~ (-1) / m ~ (-1) .Neonatal birth weight was 1 500,3 600 g (mean 25556.25 鹵660.86 g / L), and 50% of the newborns were born with low body weight. Respiratory distress syndrome was transferred to pediatrics for treatment. There was no obvious abnormality in neonatal development at 1 month after birth. Conclusion: abdominal aortic balloon occlusion combined with placenta accreta resection and repair can be performed during cesarean section. Reduce intraoperative bleeding, Reducing the rate of hysterectomy is a safe, effective and effective new comprehensive therapy.
【作者單位】： 南京醫(yī)科大學(xué)第一附屬醫(yī)院婦產(chǎn)科;
【基金】：國家自然科學(xué)基金青年基金(81401229) 江蘇省青年醫(yī)學(xué)人才項(xiàng)目(QNRC2016617)
【分類號(hào)】：R719.8

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