改良式髂总动脉球囊闭塞术在控制凶险型前置胎盘剖宫产术中出血的临床研究  

Clinical analysis of bilateral internal iliac arteries balloon occlusion in controlling hemorrhage during caesarean section of pernicious placenta previa

作　　者：魏菲[1] 林珏瑛[1] 周瑞仁[1] 陈琪瑛[1] 罗翠珍[1] 杨金玲[1] 

机构地区：[1]广西南宁市第一人民医院产科,南宁市530021

出　　处：《微创医学》2016年第4期502-504,508,共4页Journal of Minimally Invasive Medicine

基　　金：广西南宁市科学研究与技术开发计划项目(编号:20153101)

摘　　要：目的探讨应用双侧髂总动脉球囊闭塞术控制凶险型前置胎盘二次剖宫产术中出血的疗效。方法回顾性分析63例接受双侧髂总动脉球囊闭塞术下二次剖宫产分娩及未行球囊闭塞术下二次剖宫产的孕妇临床资料。根据孕妇及其家属自身情况及经济条件等,自愿选择或未选择改良式髂总动脉球囊闭塞术下行二次剖宫产手术方式的不同分为两组,介入组(A组)38例选取接受双侧髂总动脉球囊闭塞术下剖宫产分娩孕产妇,非介入组(B组)25例同时期未行球囊闭塞术仅行二次剖宫产术分娩的孕产妇则按产科常规处理,行二次剖宫产。结果两组孕产妇在术中出血量、术中及术后12 h内输血量、子宫切除率、产后出血几率及输血几率比较,差异有统计学意义(P<0.05);在手术时间、凝血功能障碍、腹部切口愈合情况比较,差异无统计学意义(P>0.05)。结论剖宫产术中应用改良式双侧髂总动脉球囊闭塞术可减少术中出血量,减少输血几率,为保留子宫创造条件。Objective To explore the clinical efficacy of bilateral common iliac arteries balloon occlusion in controlling hemorrhage during caesarean section of patients with pernicious placenta previa. Methods Retrospective analysis of the cases of puerperal women of the second cesarean section between received bilateral common iliae artery balloon occlusion and non-received bilateral common iliac artery balloon occlusion. Results The differences were statistically significant between the two groups in blood loss during the operation （ P 〈 0. 05 ）, amount of blood transfusion during the operation and 12 hours after operation （P 〈0. 05 ）, hysterectomy rate （P 〈 0.05 ）, the incidence of postpartum hemorrhage （P 〈 0. 05 ） and the rate of blood transfusion （P 〈0. 05 ） ; there were no statistically significant differences between the operation time （P 〉 0.05 ）, coagulation dysfunction （ P 〉 0.05 ） and abdominal incision healing （ P 〉 0.05 ） of the two groups. Conclusion The application of bilateral common iliac artery balloon occlusion in cesarean section can reduce the amount of bleeding during operation, reduce the chance of blood transfusion, and less complications and creating conditions for the uterus.

关 键 词：髂总动脉 球囊闭塞术 凶险型前置胎盘 产后出血 

分 类 号：R719.8[医药卫生—妇产科学]