凶险性前置胎盘预置球囊阻断术辅助剖宫产球囊放置位置meta分析  

Preset balloon occlusion-assisted cesarean section for delivery women with pernicious placenta previa:a meta-analysis of balloon placement position

作　　者：胡波[1] 倪才方[1] 李智[1] 张磊[1] HU Bo;NI Caifang;LI Zhi;ZHANG Lei(Department of Interventional Radiology,First Affiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215006,China)

机构地区：[1]苏州大学附属第一医院介入科,江苏215006

出　　处：《介入放射学杂志》2020年第2期169-174,共6页Journal of Interventional Radiology

基　　金：国家自然科学基金青年科学基金(81501563);江苏省青年医学人才项目(QNRC2016711)。

摘　　要：目的采用meta分析方法对比远端腹主动脉球囊阻断和双侧髂内动脉球囊阻断在辅助凶险型前置胎盘(PPP)患者剖宫产术的安全性和有效性。方法计算机系统检索中国知网、万方和维普数据库并手工检索PPP预置球囊阻断治疗相关文献,检索时限均自建库至2018年8月30日。由2名独立评价者对纳入文献进行质量评价,采用Review Manager 5.0 for Mac软件进行meta分析。结果共有11篇文献纳入分析,结果显示腹主动脉球囊阻断组患者在术中胎儿射线接触量、手术时间、术中出血量、子宫切除率方面优于双侧髂总动脉球囊阻断组,OR(95%CI)分别为-2.57(-2.85^-2.29)、-13.28(-16.56^-10.00)、-0.35(-0.53^-0.17)、0.70(0.50~0.78),P值均<0.05。结论PPP患者剖宫产术中远端腹主动脉球囊阻断技术在术中胎儿射线接触量、总体手术时间、术中出血量和子宫切除率方面优于双侧髂内动脉球囊阻断技术,为临床治疗方式选择提供依据。Objective By using meta analysis method to compare the safety and effectiveness of distal abdominal aorta balloon occlusion with those of bilateral internal iliac artery balloon occlusion in performing cesarean section for delivery women with pernicious placenta previa(PPP).Methods Computer retrieval of CNKI,Wanfang and VIP databases was conducted to collect the eligible clinical research documents concerning the preset balloon occlusion-assisted cesarean section for delivery women with PPP.The retrieval time was from the establishment of database to August 30,2018.Two independent physicians evaluated the quality of the included literature.Review Manager 5.0 for Mac software was used to perform meta-analysis.Results A total of 11 documents were included in the meta-analysis.The results showed that intraoperative radiation exposure dose to fetus,the time spent for operation,the amount of bleeding and the hysterectomy rate in the abdominal aortic balloon occlusion group were superior to those in the bilateral common iliac artery balloon occlusion group,the statistical results were(OR=-2.57,95%CI:-2.85 to-2.29,P<0.01),(OR=-13.28,95%CI:--16.56 to-10.00),P<0.01),(OR=-0.35,95%CI:-0.53 to-0.17,P<0.01)and(OR=0.70,95%CI:0.50-0.78,P=0.04),respectively.Conclusion For the performance of cesarean section in delivery women with PPP,balloon occlusion of distal abdominal aorta is superior to bilateral common iliac artery balloon occlusion in intraoperative radiation exposure dose to fetus,the time spent for operation and the amount of bleeding and the hysterectomy rate.This study provides the basis for the selection of clinical treatment methods.

关 键 词：凶险型前置胎盘 球囊阻断 远端腹主动脉 双侧髂内动脉 META分析 

分 类 号：R714[医药卫生—妇产科学]