球囊封堵术在产科大出血的临床应用

发布时间：2018-10-05 17:26

【摘要】：目的探讨球囊封堵术治疗凶险性前置胎盘的临床疗效。方法 2015年1月至2016年3月采用球囊封堵术协助产科处理凶险性前置胎盘产妇16例。15例经彩色超声或MRI诊断为中央型前置胎盘并高度怀疑胎盘植入,择期于剖宫产前双侧髂内动脉预置球囊,胎儿取出同时立即充盈双侧球囊对目标血管作临时封堵,根据产科医师止血状况适时撤出球囊;1例行急症腹主动脉临时球囊封堵术,开腹发现胎盘穿透至前壁浆膜下,予子宫切除术。结果 16例球囊封堵术均获成功,平均阻断时间15 min,出血量300~1 200 ml。结论剖宫产手术前球囊封堵术治疗凶险性前置胎盘安全可靠,可显著减少术中出血、迅速有效止血、为剖宫产提供清晰术野及挽救产妇生命,充分体现产科、介入科等多学科协作的必要性。
[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.
【作者单位】：曲靖市第一人民医院介入科;
【分类号】：R714.461

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