剖宫产术前行腹主动脉球囊导管预置术对凶险型前置胎盘合并胎盘植入孕妇及胎儿的影响  

Effects of Abdominal Aortic Balloon Catheterization before Cesarean Section on Pregnant Women and Fetuses of Patients with Dangerous Placenta Previa Combined with Placenta Accreta

作　　者：甘艳琼 张娟[1] 邵建兰[1] 

机构地区：[1]川北医学院附属医院妇产科,四川南充637000

出　　处：《解放军医药杂志》2017年第10期54-57,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：四川省卫生和计划生育委员会科研课题(150052)

摘　　要：目的探讨剖宫产术前行腹主动脉球囊导管预置术对凶险型前置胎盘合并胎盘植入孕妇及其胎儿的影响。方法选取2015年1月—2017年1月川北医学院附属医院收治的66例凶险型前置胎盘合并胎盘植入66例,按是否行腹主动脉球囊导管预置术分为观察组与对照组,每组33例。观察组于剖宫产术前行腹主动脉球囊导管预置术,术中充盈球囊临时阻断主动脉血流;对照组未行腹主动脉球囊导管预置术。分析2组术中、术后及胎儿情况。结果观察组手术时间和凝血酶原时间短于对照组,术中输血量和出血量少于对照组(P<0.05)。观察组住院天数短于对照组,ICU转入率低于对照组(P<0.05)。2组新生儿Apgar评分和出生体质量比较差异无统计学意义(P>0.05)。结论剖宫产前对凶险型前置胎盘合并胎盘植入孕妇行腹主动脉球囊导管预置术,可以完成剥离胎盘及子宫修补术,减少术中出血量,降低子宫切除率。Objective To investigate effects of abdominal aortic balloon catheterization on pregnant women and their fetuses of patients with dangerous placenta previa combined with placenta accreta. Methods A total of 66 patients with dangerous placenta previa combined with placenta accreta admitted during January 2015 and January 2017 were di-vided into observation group and control group （ n=33 for each group） according to whether or not having abdominal aor-tic balloon catheterization. Observation group was treated with abdominal aortic balloon catheterization before cesarean section and intraoperative filling balloon to provisionally block aortic flow, while control group did not been performed ab-dominal aortic balloon catheterization. Intraoperative and postoperative and fetuses condition were analyzed in two groups. Results In observation group, operative time and prothrombin time were significantly shorter, and intraoperative vol-umes of blood transfusion and blood loss were significantly less （P〈0. 05）;hospital stay was significantly shorter, and transferred rate of ICU was significantly lower than those in control group （P〈0. 05）. There were no significantly differ-ences in Apgar score and birth mass of fetuses between the two groups （P〉0. 05）. Conclusion Abdominal aortic bal-loon catheterization in treatment of pregnant women with dangerous placenta previa combined with placenta accreta can perform stripping placenta and uterine repair surgery, reduce intraoperative volume of blood loss and hysterectomy rate.

关 键 词：前置胎盘 侵入性胎盘 剖宫产术 腹主动脉球囊导管预置术 产后出血 

分 类 号：R714.4[医药卫生—妇产科学]