凶险型前置胎盘剖宫产术中腹主动脉球囊阻断术联合子宫胎盘植入部位切除及修补术的疗效探讨

发布时间：2018-03-14 20:10

本文选题：凶险型前置胎盘　切入点：胎盘植入　出处：《南京医科大学学报(自然科学版)》2017年11期 　论文类型：期刊论文

【摘要】：目的:探讨剖宫产术中腹主动脉球囊阻断术联合子宫胎盘植入部位切除及修补术的疗效。方法 :回顾性分析2016年9—12月南京某院收治的12例凶险型前置胎盘伴胎盘植入患者的手术方式及处理流程。结果:12例术中出血600~4 000 m L,术中平均失血(2 325.00±1 453.81)m L。输注红细胞悬液0~15 U,平均(7.38±5.13)U。输注血浆0~1 000 m L,平均(518.75±304.65)m L。产后24 h出血量670~4 230 m L,平均出血量(2 413.75±1 460.50)m L。所有患者均未发生弥散性血管内凝血,无穿刺部位血肿形成。术后1周下肢动脉B超未见明显异常,术后1周血人绒毛膜促性腺激素13.71~5 382.00 m U/m L,平均(797.68±1 532.07)m U/m L。新生儿出生体重1 500~3 600g,平均(2 556.25±660.86)g,50%新生儿因低体重、呼吸窘迫综合征等原因转儿科治疗。出生后1个月随访新生儿发育无明显异常。结论:剖宫产术中腹主动脉球囊阻断术联合子宫胎盘植入部位切除及修补术能有效减少术中出血,降低子宫切除率,是一种安全、有效、可施行的综合治疗新方法。
[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 卤1 453.81mL during operation were treated with disc implantation. The erythrocyte suspension was injected with 0.15 U, mean 7.38 卤5.13 渭. Plasma was injected with plasma 0.000 mL (mean 518.75 卤304.65 min / L). The volume of blood loss at 24 hours postpartum was 670m / 4. 230ml, the mean bleeding volume was 2413.75 卤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 卤1 532.07 m / m ~ (-1) / m ~ (-1) .Neonatal birth weight was 1 500,3 600 g (mean 25556.25 卤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.
【作者单位】：南京医科大学第一附属医院妇产科;
【基金】：国家自然科学基金青年基金(81401229) 江苏省青年医学人才项目(QNRC2016617)
【分类号】：R719.8

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