髂内动脉球囊预留植入术在产后出血高危患者中的应用研究  

Application of perioperative internal iliac artery balloon occlusion in patients at high risk of postpartum hemorrhage

作　　者：谢雷[1] 林进[1] 梁威飘 陈广幸[1] 刘楚芹 邱国时 XIE Lei;LIN Jin;LIANG Wei-piao(Department of Radiology,Second People's Hospital of Zhaoqing,Zhaoqing Guangdong 526060,China)

机构地区：[1]肇庆市第二人民医院放射科,广东肇庆526060

出　　处：《临床和实验医学杂志》2020年第19期2103-2106,共4页Journal of Clinical and Experimental Medicine

基　　金：广东省自然科学基金(编号:06301077);肇庆市科技创新计划项目(编号:201704031418)。

摘　　要：目的探讨髂内动脉球囊预留植入术在不同类型的产后出血高危患者中的应用价值。方法回顾性选取2017年10月至2019年10月于肇庆市第二人民医院分娩并接受了髂内动脉球囊预留植入术的产后出血高危患者20例作为研究组。另选取2015年12月至2016年12月接受剖宫产手术但未接受髂内动脉球囊预留植入术的产妇20例作为对照组。研究组采用了髂内动脉球囊预留植入术预防产后出血,对照组接受常规产后出血止血措施。统计两组分娩后1min、5min、10min新生儿阿氏(Apgar)评分,体重,身高,术中出血量,输血量,剖宫产手术时间,子宫切除率,新生儿窒息发生率和母乳喂养率。随访1年内两组再次出血率及并发症发生率。结果两组分娩后1min、5min、10min新生儿Apgar评分,随时间推移而增大,逐渐接近10分;分娩后各时间点两组新生儿Apgar评分、体重、身高比较无显著差异(P>0.05)。研究组出血量明显小于对照组(1346.25±306.17mLvs.1654.68±573.24mL),差异有统计学意义(P<0.05);两组剖宫产时间比较差异无统计学意义(127.92±54.61minvs.136.53±59.24min,P>0.05)。研究组母乳喂养率85.00%明显高于对照组55.00%,差异有统计学意义(P<0.05)。研究组20例患者在接受髂内动脉球囊预留植入术均止血成功,获得良好止血效果。结论髂内动脉球囊预留植入术对不同类型的产后出血高危患者均具有较好止血效果,且无明显产后严重并发症,具有一定安全性。Objective To investigate the application of perioperative internal iliac artery balloon occlusion in patients at high risk of postpartum hemorrhage.Methods 20 women with high risk of postpartum hemorrhage who received the perioperative internal iliac artery balloon occlusion and delivered in our hospital from October 2017 to October 2018 were enrolled as study group,meanwhile,another 20 women with the same clinical indicators who receive routinepostpartum hemostasisschemes and delivered in our hospital from December 2015 to December 2016 were retrospectively enrolled as control group.Then the Apgar score,body weight,height,intraoperative blood loss,transfusion volume,duration of cesarean section,hysterectomy rate,neonatal asphyxia rate,breastfeeding rate,rebleeding rate and complication rate were recorded.Results There was an increasing trend in Apgar score of neonates in the two groups at 1 min,5 min and 10 min after delivery,and gradually approaching 1o points,with no statistic difference between groups after delivery(P>0.05).The amount of bleeding in the study group was significantly less than that in the control group(1346.25±306.17 mL vs.1654.68±573.24 mL,P<0.05),and there was no significant difference in the duration of cesarean section between the two groups(127.92±54.61 min vs.136.53±59.24 min,P>0.05).The breastfeeding rate of the study group was significantly higher than that of the control group(P<0.05).All patients in study group achieved good hemostasis effect.Conclusion Perioperative internal iliac artery balloon occlusion forwomen with high risk of postpartum hemorrhage before delivery has good hemostatic effect,with no significant postpartum serious complications.

关 键 词：产后出血高危患者 髂内动脉球囊预留植入术 应用价值 

分 类 号：R714.461[医药卫生—妇产科学]