间歇性腹主动脉阻断联合剖宫产术治疗凶险性前置胎盘合并胎盘植入的效果观察  

Effect of intermittent abdominal aorta occlusion combined with cesarean section in the treatment of dangerous placenta previa with placenta accreta

作　　者：马迎萍 聂伟 王荣兰 刘武军[3] Ma Yingping;Nie Wei;Wang Ronglan;Liu Wujun(Department of Maternity,Qinghai Women and Children Hospital,Xining 810000,China;Department of Pathology,Qinghai Maternal and Child Health Hospital,Xining 810000,China;Department of Intervention,Qinghai Provincial people's Hospital,Xining 810000,China)

机构地区：[1]青海省妇女儿童医院妇产科,西宁810000 [2]青海省妇幼保健院病理科,西宁810000 [3]青海省人民医院介入科,西宁810000

出　　处：《中国医学前沿杂志（电子版）》2020年第3期112-115,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的观察间歇性腹主动脉阻断联合剖宫产术治疗凶险性前置胎盘合并胎盘植入的临床效果。方法选取青海省妇女儿童医院2016年3月至2018年9月收治的凶险性前置胎盘合并胎盘植入产妇23例为研究对象,将行间歇性术中腹主动脉阻断联合剖宫产术的产妇纳入观察组(10例),将行剖宫产术的产妇纳入对照组(13例),对比两组产妇的术中出血量、术中输血量、手术时间、新生儿评分、术后并发症发生率、病死率。结果观察组产妇术中出血量和术中输血量均显著少于对照组(均P<0.01),手术时间显著短于对照组(P<0.01)。观察组产妇出血宫颈填塞后无效并行子宫切除1例,其余产妇止血效果均良好,术后1周内康复出院。对照组产妇出血宫颈填塞9例,止血效果良好4例,效果不佳而行子宫切除术5例。观察组产妇术后并发症发生率显著低于对照组(P<0.05),两组新生儿Apgar评分和产妇病死率比较差异均无统计学意义(均P>0.05)。结论间歇性腹主动脉阻断联合剖宫产术能够减少凶险性前置胎盘合并胎盘植入产妇的术中出血量和输血量,缩短手术时间,降低术后并发症发生率,但对凶险性前置胎盘合并胎盘植入产妇的病死率和新生儿评分均无显著影响。Objective To observe the clinical effect of intermittent abdominal aorta occlusion combined with cesarean section in the treatment of dangerous placenta previa with placenta accreta.Method Twenty-three parturients with dangerous placenta previa with placenta accreta treated in Qinghai Women and Children's Hospital from March 2016 to September 2018 were selected as the objects of study,the parturients who underwent intermittent aortic clamping combined with cesarean section were included in observation group(n=10),and the parturients who underwent cesarean section were included in control group(n=13).The intraoperative blood loss,blood transfusion,operation time,neonatal score,incidence of postoperative complications and mortality were compared between the two groups.Result The amount of intraoperative blood loss and intraoperative blood transfusion in observation group were significantly less than those in control group(all P<0.01),and the operation time in observation group was significantly shorter than that in control group(P<0.01).In observation group,1 parturient had no effect after sequential cervical packing and hysterectomy,and the rest of the parturients had good hemostatic effect and were recovered and discharged from hospital within 1 week after operation.In control group,cervical packing occurred in 9 cases,hemostatic effect was good in 4 cases,and hysterectomy was performed in 5 cases.The incidence of postoperative complications in observation group was significantly lower than that in control group(P<0.05).There was no significant difference in neonatal Apgar score and maternal mortality between the two groups(all P>0.05).Conclusion Intermittent abdominal aorta occlusion combined with cesarean section can reduce the amount of intraoperative blood loss and blood transfusion,shorten the operation time and reduce the incidence of postoperative complications in parturients with dangerous placenta previa and placenta accreta,however,it has no significant effect on the mortality and neonatal score of part

关 键 词：间歇性腹主动脉阻断 剖宫产术 前置胎盘 胎盘植入 

分 类 号：R719.8[医药卫生—妇产科学]