低位腹主动脉球囊阻断在凶险型前置胎盘中的应用价值  

Application Value of Lower Abdominal Aorta Balloon Occlusion in Pernicious Placenta Previa

作　　者：李晓燕[1] 王晓黎[1] 李蕾[1] 于晓艳[1] 崔青[1] 

机构地区：[1]山东省烟台毓璜顶医院产科,264000

出　　处：《国际妇产科学杂志》2016年第3期291-294,共4页Journal of International Obstetrics and Gynecology

摘　　要：凶险型前置胎盘近年呈上升趋势,可伴有胎盘植入,是凶险性产后出血的主要原因,临床处理困难,严重威胁孕产妇的生命。其发病原因主要与手术后瘢痕形成过程中子宫蜕膜发育与滋养细胞侵袭之间的平衡失调有关。有效地控制产时、产后出血是抢救凶险型前置胎盘成功的关键,目前临床上常用的方法有子宫内、外压迫法、子宫动脉上行支结扎术、局部压迫缝合术、髂内动脉或子宫动脉栓塞术等。低位腹主动脉球囊阻断法操作简单易行,止血效果确切,射线暴露时间短,对胎儿无影响,对全身血流动力学影响小,可使术野清晰,给予术者一定的时间综合判断处理,在凶险型前置胎盘或胎盘植入中的应用逐渐体现出优势,有望成为减少产后出血的有效预防手段。Incidence of pernicious placenta previa present a trend of rising in recent years. Pernicious previa complicating placenta increta is the leading cause of postpartum hemorrhage. The clinical treatment of the above condition is rather difficult and poses a serious threat to maternal life. The main contributory factor is the imbalance between uterine decidua development and chorionic villi cells invasion during uterin scaring formation process. Effective treatment of intrapartum and postpartum hemorrhage is the key to deal with pernicious placenta previa. Nowadays, treatment options for placenta previa include internal and external compression of uterine, selective devascularization by ligation of the upper branch of the uterine artery,local compression with uterine sutures, iliac artery embolization and uterine artery embolization. Lower abdominal aorta balloon occlusion is a feasible procedure that can effectively reduce the amount of bleeding, requires a short X-rays exposure time, does not impair fetal, less affect maternal blood circulation, makes surgery area clear, and gives operator the chance to consider carefully to make a decision. Lower abdominal aorta balloon occlusion presents more and more advantages to treat pernicious placenta previa and may be an effective preventive measure to reduce postpartum hemorrhage in the future.

关 键 词：前置胎盘 胎盘 侵入性 气囊扩张术 主动脉 腹 产后出血 

分 类 号：R714.2[医药卫生—妇产科学]