凶险性前置胎盘伴胎盘植入剖宫产术中应用髂内动脉球囊阻断术38例临床分析

发布时间：2019-01-08 14:10

【摘要】：目的:评估髂内动脉球囊阻断术在凶险性前置胎盘伴胎盘植入患者剖宫产术中的意义。方法:回顾性分析四川大学华西第二医院2012年3月至2015年10月81例凶险性前置胎盘伴胎盘植入患者的临床资料,将剖宫产术中应用髂内动脉球囊阻断术的患者列入研究组(n=38),未使用者列入对照组(n=43),比较两组在剖宫产术中的出血量、输红细胞量、手术时间、新生儿窒息率、子宫切除率、术后住院时间等指标。结果:研究组术中出血量中位数为1650 ml(500~7800 ml),对照组为2000 ml(1000~12800 ml),两组比较差异有统计学意义(P0.05);研究组术中输入红细胞量中位数为3.0 U(0~18.0 U),对照组为6.0 U(0~27.0 U),两组比较差异有统计学意义(P0.05)。两组患者在手术时间、新生儿窒息率、术后住院时间及子宫切除率方面比较差异均无统计学意义(P0.05)。子宫全切球囊组与子宫全切对照组在术中出血量、输红细胞量、手术时间、术后住院时间比较,差异均无统计学意义(P0.05)。结论:凶险性前置胎盘伴胎盘植入患者剖宫产术中采用髂内动脉球囊阻断术可以减少术中出血量及输红细胞量,但不能降低子宫切除率。
[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.
【作者单位】：四川大学华西第二医院出生缺陷与相关妇儿疾病教育部重点实验室;郑州大学第一附属医院;
【基金】：四川省科技厅应用基础项目(编号:2015JY0134)
【分类号】：R719.8

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