腹主动脉球囊阻断术在凶险性前置胎盘并胎盘植入剖宫产术中的应用

发布时间：2018-05-13 05:04

本文选题：腹主动脉阻断 + 凶险性前置胎盘　；参考：《山东大学学报(医学版)》2016年09期

【摘要】：目的探讨腹主动脉球囊阻断术在凶险性前置胎盘并胎盘植入患者剖宫产术中的临床应用。方法回顾分析65例凶险性前置胎盘并胎盘植入患者的临床资料。全部患者均于剖宫产术前在介入室行股动脉插管并送入球囊导管,球囊放置于腹主动脉下段,手术中充盈球囊临时阻断主动脉血流。记录剖宫产术中出血量、子宫切除例数、孕妇接受射线剂量。结果手术中出血量200~4 500 m L,平均1 520 m L;术中、术后输红细胞0~3 600 m L,平均1 040 m L;无产妇及胎儿死亡及严重并发症。7例行子宫切除术(10.8%)。结论腹主动脉球囊阻断术可有效控制凶险性前置胎盘剖宫产术中出血、减少子宫切除率,辐射剂量对胎儿安全。但风险不可忽视,应严格掌握适应证。
[Abstract]:Objective to investigate the clinical application of abdominal aortic balloon occlusion during cesarean section in patients with severe placenta previa and placenta accreta. Methods the clinical data of 65 patients with dangerous placenta previa associated with placenta accreta were retrospectively analyzed. All the patients underwent femoral artery catheterization in interventional ventricle before cesarean section and were placed into balloon catheter. The balloon was placed in the lower segment of abdominal aorta and the aortic blood flow was temporarily blocked by balloon during the operation. The volume of bleeding during cesarean section, the number of cases of hysterectomy and the dose of radiation to pregnant women were recorded. Results the volume of blood loss during the operation was 200 ~ 4 500 mL (mean, 1 520 mL), during the operation, erythrocyte transfusion was 3 600 mL with an average of 1 040 mL, and there was no maternal and fetal death and severe complications. 7 cases were treated with hysterectomy. Conclusion abdominal aortic balloon occlusion can effectively control the bleeding during caesarean section of dangerous placenta previa, reduce the rate of hysterectomy, and the radiation dose is safe for fetus. But the risk should not be ignored and the indication should be strictly grasped.
【作者单位】：山东省医学影像学研究所介入放射学研究室;山东大学附属省立医院妇产科;
【基金】：山东省科技发展计划(2014GSF118088) 山东省自然科技基金(ZR2013HM067)
【分类号】：R719.8

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