【摘要】：目的:評(píng)估髂內(nèi)動(dòng)脈球囊阻斷術(shù)在兇險(xiǎn)性前置胎盤伴胎盤植入患者剖宮產(chǎn)術(shù)中的意義。方法:回顧性分析四川大學(xué)華西第二醫(yī)院2012年3月至2015年10月81例兇險(xiǎn)性前置胎盤伴胎盤植入患者的臨床資料,將剖宮產(chǎn)術(shù)中應(yīng)用髂內(nèi)動(dòng)脈球囊阻斷術(shù)的患者列入研究組(n=38),未使用者列入對(duì)照組(n=43),比較兩組在剖宮產(chǎn)術(shù)中的出血量、輸紅細(xì)胞量、手術(shù)時(shí)間、新生兒窒息率、子宮切除率、術(shù)后住院時(shí)間等指標(biāo)。結(jié)果:研究組術(shù)中出血量中位數(shù)為1650 ml(500~7800 ml),對(duì)照組為2000 ml(1000~12800 ml),兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);研究組術(shù)中輸入紅細(xì)胞量中位數(shù)為3.0 U(0~18.0 U),對(duì)照組為6.0 U(0~27.0 U),兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者在手術(shù)時(shí)間、新生兒窒息率、術(shù)后住院時(shí)間及子宮切除率方面比較差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。子宮全切球囊組與子宮全切對(duì)照組在術(shù)中出血量、輸紅細(xì)胞量、手術(shù)時(shí)間、術(shù)后住院時(shí)間比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:兇險(xiǎn)性前置胎盤伴胎盤植入患者剖宮產(chǎn)術(shù)中采用髂內(nèi)動(dòng)脈球囊阻斷術(shù)可以減少術(shù)中出血量及輸紅細(xì)胞量,但不能降低子宮切除率。
[Abstract]:Objective: to evaluate the significance of balloon occlusion of internal iliac artery during cesarean section in patients with severe placenta previa associated with placenta accreta. Methods: the clinical data of 81 cases of dangerous placenta previa with placenta accreta from March 2012 to October 2015 in Huaxi second Hospital of Sichuan University were analyzed retrospectively. The patients who received balloon occlusion of internal iliac artery during cesarean section were included in the study group (n = 38) and the control group (n = 43). The blood loss, erythrocyte transfusion, operation time and neonatal asphyxia rate were compared between the two groups during cesarean section. Hysterectomy rate, postoperative hospitalization time and other indicators. Results: the median amount of intraoperative bleeding in the study group was 1650 ml (500,7800 ml),) and the control group was 2000 ml (1000,12800 ml),). There was significant difference between the two groups (P0.05). The median of red blood cell input in the study group was 3. 0 U (0 ~ 18. 0 U), vs 6. 0 U) (0 ~ 27. 0 U),). There was significant difference between the two groups (P0.05). There was no significant difference in operation time, neonatal asphyxia rate, postoperative hospitalization time and hysterectomy rate between the two groups (P0.05). There was no significant difference between the total uterine balloon group and the total hysterectomy control group in intraoperative blood loss, erythrocyte transfusion, operation time, postoperative hospitalization time (P0.05). Conclusion: balloon occlusion of internal iliac artery during cesarean section in patients with dangerous placenta previa and placenta accreta can reduce the amount of blood loss and red blood cell transfusion, but can not reduce the rate of hysterectomy.
【作者單位】： 四川大學(xué)華西第二醫(yī)院出生缺陷與相關(guān)婦兒疾病教育部重點(diǎn)實(shí)驗(yàn)室;鄭州大學(xué)第一附屬醫(yī)院;
【基金】：四川省科技廳應(yīng)用基礎(chǔ)項(xiàng)目(編號(hào):2015JY0134)
【分類號(hào)】：R719.8

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