胎儿娩出前与娩出后低位腹主动脉球囊阻断对凶险型前置胎盘合并胎盘植入的治疗效果  

Therapeutic effect of low abdominal aortic balloon occlusion before and after fetal delivery on pernicious placenta previa complicated with placenta implantation.

作　　者：乔媛 贺同强 王瑞 魏旸 吕艳香 呼瑞 汪瑜 QIAO Yuan;HE Tong-qiang;WANG Rui;WEI Yang;LV Yan-xiang;HU Rui;WANG Yu(Intensive Care Unit,Department of Obstetrics and Gynecology,First Department of Obstetrics,Xi'an 710061,Shaanxi,CHINA;Intensive Care Unit,Department of Obstetrics and Gynecology,Department of Neonatal Intensive Care,Xi'an 710061,Shaanxi,CHINA;Intensive Care Unit,Department of Obstetrics and Gynecology,Northwest Women's and Children's Hospital,Xi'an 710061,Shaanxi,CHINA)

机构地区：[1]西北妇女儿童医院妇产科重症监护室,陕西西安710061 [2]西北妇女儿童医院妇产科产一科,陕西西安710061 [3]西北妇女儿童医院妇产科新生儿重症科,陕西西安710061

出　　处：《海南医学》2022年第16期2109-2112,共4页Hainan Medical Journal

基　　金：陕西省科技厅项目(编号:2018SF-078)。

摘　　要：目的比较胎儿娩出前与胎儿娩出后进行低位腹主动脉球囊阻断对凶险型前置胎盘(PPP)合并胎盘植入的治疗效果。方法回顾性分析2018年1月至2021年1月于西北妇女儿童医院产科住院且接受低位腹主动脉球囊阻断术的140例PPP合并胎盘植入患者的临床资料。根据阻断时机不同分组,其中67例在胎儿娩出前进行低位腹主动脉球囊阻断术者纳入观察组,73例在胎儿娩出后进行低位腹主动脉球囊阻断术者纳入对照组。比较两组患者术中、术后相关情况,子宫切除率、新生儿情况以及术后并发症发生率。结果观察组患者的手术时间为(79.28±15.33)min,略短于对照组的(83.45±16.24)min,子宫切除率为2.99%,略低于对照组的4.11%,但差异均无统计学意义(P>0.05);观察组患者的术中失血量为(590.15±54.04)mL,明显少于对照组的(879.15±35.33)mL,术后住院时间为(4.84±0.78)d,明显短于对照组的(6.22±0.83)d,差异均有统计学意义(P<0.05);两组新生儿出生后1min、5 min和10 min的Apgar评分≤7分占比比较差异均无统计学意义(P>0.05);观察组患者术后并发症发生率为11.94%,略低于对照组的17.81%,但差异无统计学意义(P>0.05)。结论与胎儿娩出后进行低位腹主动脉球囊阻断治疗PPP合并胎盘植入相比,胎儿娩出前进行低位腹主动脉球囊阻断能有效减少术中出血量,缩短患者手术后住院时间,但两种手术方式的手术时间、对新生儿出生后Apgar评分、术中子宫切除率以及术后并发症发生情况的影响无明显差异。Objective To analyze the therapeutic effect of low abdominal aorta balloon occlusion before and af-ter fetal delivery on pernicious placenta previa(PPP)complicated with placenta implantation.Methods A retrospective analysis was performed on 140 patients with PPP complicated with placenta implantation who received low abdominal aortic balloon occlusion in Department of Obstetrics,Northwest Women's and Children's Hospital from January 2018 to January 2021.According to the timing of occlusion,the patients were divided into an observation group(67 patients)and a control group(73 patients),which were treated with low abdominal aortic balloon occlusion before fetal delivery and low abdominal aortic balloon occlusion after fetal delivery,respectively.The intraoperative and postoperative conditions,hysterectomy rate,neonatal situation,and incidence of postoperative complications were compared between the two groups.Results The operation time was(79.28±15.33)min of the observation group versus(83.45±16.24)min of the control group,and the hysterectomy rate was 2.99%in the observation group versus 4.11%in the control group,with no statistically significant differences(P<0.05).The intraoperative blood loss was(590.15±54.04)mL of the observation group,significantly less than(879.15±35.33)mL of the control group(P<0.05),and the postoperative length of hospital stay of the observation group was(4.84±0.78)d,which was significantly shorter than(6.22±0.83)d of the control group,with statistically significant differences(P<0.05).The proportions of patients with Apgar score≤7 at 1 min,5 min,and 10 min in the observation group showed no statistically significant difference between the two groups(P>0.05).The inci-dence of postoperative complications in the observation group(11.94%)was slightly lower than that in the control group(17.81%),but the difference was not statistically significant(P>0.05).Conclusion Compared with low abdominal aor-tic balloon occlusion after fetal delivery,low abdominal aortic balloon occlusion before

关 键 词：腹主动脉球囊阻断 凶险型前置胎盘 胎盘植入 Apgar评分 术后并发症 

分 类 号：R714.43[医药卫生—妇产科学]