超声导引下腹主动脉球囊预置新方法预防产后出血  

A new method of ultrasound-guided pre-implantation of abdominal aorta balloon for prevention of postpartum hemorrhage

作　　者：刘军乐[1] 付大鹏[1] 石燕[1] 丁锦辉[1] 丁贺义 胡杨刚[1] 陆信武[2] LIU Junle;FU Dapeng;SHI Yan;DING Jinhui;DING Heyi;HU Yanggang;LU Xinwu(Department of Vascular Surgery, Karamay Municipal Central Hospital, Karamay, Xinjiang Uygur Autonomous Region 834000, China)

机构地区：[1]新疆克拉玛依市中心医院血管外科,834000 [2]上海交通大学医学院附属第九人民医院血管外科、上海交通大学血管病诊治中心

出　　处：《介入放射学杂志》2018年第12期1144-1147,共4页Journal of Interventional Radiology

基　　金：新疆维吾尔自治区自然科学基金(2017D01A15).

摘　　要：目的探讨超声导引下腹主动脉球囊预置新方法在预防前置胎盘剖宫产术后出血的临床价值。方法 16例孕产妇经彩色超声、MR诊断为凶险性前置胎盘或中央型前置胎盘伴胎盘植入,剖宫产前通过超声导引预置下腹主动脉球囊,术中间歇阻断腹主动脉。记录术中出血量、输血量及子宫缝合时间。结果 16例均成功接受超声导引下预置球囊阻断腹主动脉,剖宫产术中平均出血量(756±222) m L,输血量(440±219) m L,子宫缝合时间(28.4±7.9) min。胎儿娩出后DSA下检查球囊置放位置准确,无明显移位。结论超声导引下腹主动脉球囊阻断术操作简单、安全,在前置胎盘伴胎盘植入产妇剖宫产术中控制出血效果显著,避免了X射线和对比剂对胎儿的不良影响。Objective To discuss the clinical value of a new method of ultrasound-guided preimplantation of abdominal aorta balloon in prevention of postpartum hemorrhage after cesarean section due to placenta previa. Methods A total of 16 delivery women with dangerous placenta previa or central placenta previa complicated by placenta implantation, which were confirmed by color ultrasound and MR, were enrolled in this study. Ultrasound-guided pre-implantation of abdominal aorta balloon was performed before cesarean section was carried out, intermittent occlusion of abdominal aorta was employed during the procedure. The amount of intraoperative blood loss, the volume of blood transfusion, and the time spent for uterine suture were recorded. Results Successful ultrasound-guided pre-implantation of abdominal aorta balloon was accomplished in all 16 delivery women. During the procedure of cesarean section, the amount of blood loss was(756±222) m L, the volume of blood transfusion was(440±219) m L, and the time spent for uterine suture was(28.4 ±7.9) min. DSA examination performed after fetus was delivery showed that the location of the balloon placement was accurate with no obvious displacement. Conclusion The ultrasound-guided abdominal aortic balloon occlusion technique is simple and safe. It has significant bleeding-control effect in the performance of cesarean section in delivery women with placenta previa complicated by placenta implantation, and the adverse effects of X-rays and contrast agents on the fetus can be avoided.

关 键 词：腹主动脉 球囊阻断 产后出血 前置胎盘 剖宫产 

分 类 号：R714.46[医药卫生—妇产科学]