髂内动脉球囊临时阻断技术在凶险型前置胎盘围手术期的应用  

Application of temporary internal iliac artery balloon occlusion in patients with pernicious placenta previa during the perioperative period

作　　者：卢敏[1] 吴宁[2] 黄珊萍[1] 许艳[1] 

机构地区：[1]海南省人民医院产科,海南海口570311 [2]海南省人民医院放射介入科,海南海口570311

出　　处：《中国妇幼保健》2016年第12期2446-2449,共4页Maternal and Child Health Care of China

基　　金：海南省自然科学基金(琼科814320);海南省卫生厅普通科研项目(琼卫13A210303)资助

摘　　要：目的评价髂内动脉球囊临时阻断技术在控制凶险型前置胎盘围手术期出血的作用。方法 13例凶险型前置胎盘患者在剖宫产术前双侧髂内动脉预留球囊导管,术中充盈球囊临时阻断髂内动脉以控制剖宫产术中出血。同时选择该科前期用传统方法处理的13例凶险型前置胎盘病例。严密观察术中血流动力学变化,比较两组术中出血量、输血量、术后24h内出血量、子宫切除率及新生儿情况等。结果球囊阻断组术中血流动力学稳定,术中出血量、输血量、输液量、子宫切除数、DIC发生数等均明显低于对照组(P<0.05);两组术后均无严重并发症发生;两组新生儿情况比较无统计学差异。结论对于凶险型前置胎盘患者,髂内动脉球囊临时阻断技术微创、止血效果确切,能有效避免大量输血和子宫切除,是一种可行的新方法,值得临床推广应用。Objective To evaluate the efficacy of temporary internal iliac artery balloon occlusion in controlling perioperative hemor- rhage of pernicious placenta prcvia. Methods A total of 13 patients with pernicious placenta previa had preserved balloon ducts in internal iliac artery before cesarean section; to control hemorrhage during operation, balloons were filled to block lilac artery temporarily. Meanwhile, 13 cases with pernicious placenta previa who received traditional treatment were chosen as contro! group. The hemodynamic changes were mo- nitored closely, and the amounts of blood loss during operation, blood transfusion volumes during operation, the amounts of blood loss within 24 hours after operation, hysterectomy rates, and neonatal conditions were compared between the two groups. Results The hemodynamics in balloon occlusion group was stable during operation. The amount of blood loss during operation, blood transfusion and transfusion volume during operation, the number of hysterectomy and DIC were statistically significantly lower than those in control group （ P〈O. 05 ） ; no serious complications occurred in any of the two groups after cesarean section ; there were no significant difference in neonatal conditions between the two groups. Conclusion For the patients with pernicious placenta previa, temporary internal iliac artery balloon occlusion is minimal inva- sire with exact effect on hemostasis, which can avoid excessive blood transfusion and hysterectomy. Consequently, it is a feasible new method and worthy of clinical promotion and application.

关 键 词：球囊阻断 前置胎盘 髂内动脉 产后出血 

分 类 号：R714[医药卫生—妇产科学]