球囊临时阻断技术在凶险性前置胎盘剖宫产术中的应用

发布时间：2018-03-29 22:24

  本文选题：凶险性前置胎盘　切入点：胎盘植入　出处：《介入放射学杂志》2017年05期

【摘要】：目的比较不同球囊阻断技术用于凶险性前置胎盘剖宫产术中的安全性、有效性。方法回顾性分析2014年3月至2016年4月施行剖宫产术的15例凶险性前置胎盘患者。为减少术中出血并尽可能保留子宫,其中7例接受腹主动脉球囊临时阻断术(A组),8例接受双侧髂内动脉球囊临时阻断术(B组)。记录并比较两组患者介入术中辐射剂量,剖宫产术中出血量、输血量、子宫切除率,术后住院时间及介入相关并发症。结果 15例患者均为中央型前置胎盘伴胎盘植入广泛,在球囊临时阻断辅助下均顺利实施剖宫产手术。7例(A组4例,B组3例)作子宫次全切,两组各1例术后出现下肢动脉血栓栓塞。A组辐射剂量明显低于B组(P0.01),术中出血量、输血量、子宫切除率、产后住院时间及介入相关并发症发生率均低于B组,但病例数有限,差异无统计学意义(P0.05)。结论球囊阻断技术辅助剖宫产术是治疗凶险性前置胎盘的安全有效方法,腹主动脉球囊临时阻断术辐射剂量明显低于双侧髂内动脉球囊临时阻断术。
[Abstract]:Objective to compare the safety of different balloon blocking techniques in severe placenta previa caesarean section. Methods Fifteen patients with dangerous placenta previa who underwent cesarean section from March 2014 to April 2016 were retrospectively analyzed. In group A, 8 cases received bilateral internal iliac artery balloon temporary occlusion of bilateral internal iliac artery. The radiation dose, blood loss, blood transfusion and hysterectomy rate during cesarean section were recorded and compared between the two groups. Results all the 15 patients were central placenta previa with extensive placenta accreta. All the 15 patients underwent cesarean section successfully with temporary balloon occlusion. Group A (n = 4) underwent subtotal hysterectomy, and group B (n = 3) underwent subtotal hysterectomy. The radiation dose in group A was significantly lower than that in group B (P 0.01). The amount of intraoperative blood loss, blood transfusion, hysterectomy rate, postpartum hospital stay and interventional complications were lower than those in group B, but the number of cases was limited. Conclusion Cesarean section with balloon blocking technique is a safe and effective method for the treatment of dangerous placenta previa. The radiation dose of temporary balloon occlusion of abdominal aorta is significantly lower than that of bilateral internal iliac artery balloon temporary occlusion.
【作者单位】： 海南省人民医院放射介入科;
【分类号】：R719.8
，

本文编号：1683140