腹主动脉阻断联合子宫动脉栓塞在九例前置胎盘并胎盘植入剖宫产手术中的应用  

The clinical application of occlusion of the lower abdominal aorta combined with uterine artery embolization in treating placenta previa associated with placenta accreta: initial experience in 9 cases

作　　者：杨厚林[1] 唐仪[1] 方主亭[1] 陈良生[1] 吴少杰[1] 

机构地区：[1]福建省立医院放射介入科,福州350001

出　　处：《介入放射学杂志》2013年第12期1036-1038,共3页Journal of Interventional Radiology

基　　金：福建省卫生厅青年科研基金资助项目(2011-1-6)

摘　　要：目的探讨球囊低位临时阻断腹主动脉联合双侧子宫动脉栓塞控制前置胎盘合并胎盘植入术中出血的效果。方法 2010年6月—2013年3月9例前置胎盘合并胎盘植入患者剖宫产手术过程中应用球囊低位临时阻断腹主动脉联合双侧子宫动脉栓塞(球囊组),并与2008年3月—2010年5月8例未行血管阻断的前置胎盘合并胎盘植入患者(对照组)进行比较,比较术中出血量、输血量、子宫壁缝合时间。结果球囊组术中出血量(786±135)ml,出血多在球囊阻断之前,输血量(422±83)ml,子宫壁缝合时间(27.9±6.9)min,球囊阻断时间(27.9±6.9)min。无明显并发症发生。对照组术中出血量(3 181±387)ml,输血量(1 487±333)ml,子宫壁缝合时间(67.4±15.4)min。两组间出血量、输血量、子宫壁缝合时间差异有统计学意义(P<0.05)。结论球囊低位临时阻断腹主动脉联合双侧子宫动脉栓塞技术能有效减少前置胎盘合并胎盘植入术中出血,是一项有临床实用价值的微创技术。Objective To investigate the effect of temporary balloon occlusion of the lower abdominal aorta combined with bilateral uterine artery embolization in controlling bleeding during the treatment of placenta previa with placenta accreta.Methods From June 2010 to March 2013 a total of 9 cases of placenta previa with placenta accreta were treated with temporary balloon occlusion of the lower abdominal aorta as well as bilateral uterine artery embolization （balloon group）.Another eight cases of placenta previa with placenta accreta,who were encountered at authors＇ hospital during the period from March 2008 to May 2010 and did not receive balloon occlusion of the lower abdominal aorta,were used as control group.The amount of blood loss and blood transfusion,and the time used for uterine suture were determined.The results were compared between the two groups.Results The amount of blood loss and blood transfusion,and the time used for uterine suture in the balloon group were（786 ± 135） ml,（422 ± 83） ml and （27.9 ± 6.9） min respectively,while those in the control group were （3 181 ± 387） ml,（1 487 ± 333） ml and （67.4 ± 15.4） min respectively.The differences between the two groups were statistically significant （P 〈 0.05）.Conclusion Temporary balloon occlusion of the lower abdominal aorta combined with bilateral uterine artery embolization can effectively reduce the amount of blood loss in treating placenta previa with placenta accreta.This technique is minimally-invasive and clinically-practical.

关 键 词：前置胎盘 胎盘植入 球囊 栓塞 出血 

分 类 号：R714.462[医药卫生—妇产科学]