【摘要】：目的探討球囊封堵術(shù)治療兇險性前置胎盤的臨床療效。方法 2015年1月至2016年3月采用球囊封堵術(shù)協(xié)助產(chǎn)科處理兇險性前置胎盤產(chǎn)婦16例。15例經(jīng)彩色超聲或MRI診斷為中央型前置胎盤并高度懷疑胎盤植入,擇期于剖宮產(chǎn)前雙側(cè)髂內(nèi)動脈預(yù)置球囊,胎兒取出同時立即充盈雙側(cè)球囊對目標(biāo)血管作臨時封堵,根據(jù)產(chǎn)科醫(yī)師止血狀況適時撤出球囊;1例行急癥腹主動脈臨時球囊封堵術(shù),開腹發(fā)現(xiàn)胎盤穿透至前壁漿膜下,予子宮切除術(shù)。結(jié)果 16例球囊封堵術(shù)均獲成功,平均阻斷時間15 min,出血量300~1 200 ml。結(jié)論剖宮產(chǎn)手術(shù)前球囊封堵術(shù)治療兇險性前置胎盤安全可靠,可顯著減少術(shù)中出血、迅速有效止血、為剖宮產(chǎn)提供清晰術(shù)野及挽救產(chǎn)婦生命,充分體現(xiàn)產(chǎn)科、介入科等多學(xué)科協(xié)作的必要性。
[Abstract]:Objective to investigate the clinical effect of balloon closure in the treatment of dangerous placenta previa. Methods from January 2015 to March 2016, balloon closure was used to assist obstetrics in the treatment of 16 cases of dangerous placenta previa. 15 cases were diagnosed by color ultrasound or MRI as central placenta previa and highly suspected placenta accreta. The bilateral internal iliac artery was preset into balloon before cesarean section, and the fetus took out and filled the bilateral balloon to make temporary closure of the target vessel. According to the hemostatic condition of obstetrician, 1 underwent temporary balloon closure of acute abdominal aorta. After laparotomy, the placenta penetrated into the serous membrane of the anterior wall and underwent hysterectomy. Results Balloon closure was successful in all 16 cases. The mean duration of occlusion was 15 min, with a blood loss of 300 ~ 1 200 ml.. Conclusion Balloon closure before cesarean section is safe and reliable in the treatment of severe placenta previa. It can significantly reduce intraoperative bleeding, quickly and effectively stop bleeding, provide clear operative field for cesarean section and save the life of parturient, and fully reflect obstetrics. The necessity of interventional multidisciplinary collaboration.
【作者單位】： 曲靖市第一人民醫(yī)院介入科;
【分類號】：R714.461

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