对比分析超声引导下与X线引导下腹主动脉球囊阻断在凶险性前置胎盘术中的应用价值  

Comparative Analysis of Ultrasound-guided and X-ray-guided Balloon Occlusion of Abdominal Aorta in the Operation of Dangerous Placenta Previa

作　　者：樊阳阳 王影 刘丹 刘飞飞 张莉莉[1] FAN Yang-yang;WANG Ying;LIU Dan;LIU Fei-fei;ZHANG Li-li(Obstetrics department,Shaanxi Provincial People's Hospital,Xian,Shaanxi,710001,China)

机构地区：[1]陕西省人民医院产科,陕西西安710001

出　　处：《现代生物医学进展》2023年第7期1349-1352,1363,共5页Progress in Modern Biomedicine

基　　金：陕西省重点研发计划项目(2022SF-209)。

摘　　要：目的:评价分析B超和X线下引导下腹主动脉预置球囊阻断术在凶险性前置胎盘剖宫产术中的应用价值。方法:收集2016年8月至2022年6月我院收治的83例凶险性前置胎盘患者病历,其中在B超引导下腹主动脉预置球囊行剖宫产术者40例(治疗组A),X线引导下腹主动脉预置球囊行43例(治疗组B)。比较分析两组患者子宫切除率和死亡率等;比较两组新生儿出生后1 min、5 min的Apgar评分;比较两组患者术后并发症发生率。结果:治疗组A手术时间短于治疗组B,治疗组A术中出血量小于治疗组B(P<0.05);两组患者术中胎盘粘连率、胎盘植入率及子宫切除率无明显差异(P>0.05);两组新生儿出生后均未出现新生儿窒息现象,治疗组A新生儿出生后1 min、5 min Apgar评分以及早产儿率与治疗组B比较均无统计学差异(P>0.05);两组患者术后总并发症发生率无差异(P>0.05)。结论:将B超下腹主动脉预置球囊阻断术应用于凶险性前置胎盘患者剖宫产,可有效减少术中和术后出血量,对新生儿出生后Apgar评分无影响,不增加术后并发症的发生。Objective:To evaluate the value of B-ultrasound and X-ray guided balloon occlusion of abdominal aorta in cesarean section of dangerous placenta previa.Methods:The medical records of 83 patients with dangerous placenta previa treated in our hospital from August 2016 to June 2022 were collected.Among them,40 patients(treatment group A)underwent cesarean section with abdominal aortic balloon under the guidance of B-ultrasound,and 43 patients(treatment group B)underwent cesarean section with abdominal aortic balloon under the guidance of X-ray.The hysterectomy rate and mortality of the two groups were compared and analyzed;Apgar scores at 1 and 5 minutes after birth were compared between the two groups;The incidence of postoperative complications was compared between the two groups.Results:The operation time of treatment group A was shorter than that of treatment group B,and the intraoperative blood loss of treatment group A was less than that of treatment group B(P<0.05).There was no significant difference in the intraoperative placental adhesion rate,placenta accreta rate and hysterectomy rate between the two groups of patients(P>0.05);There was no neonatal asphyxia in the two groups after birth,and there were no differences in the Apgar score and the rate of premature infants between the treatment group A and the treatment group B at 1 min and 5 min after birth(P>0.05).There was no difference in the total postoperative complication rate between the two groups(P>0.05).Conclusion:The application of B-ultrasound lower abdominal aorta pre-balloon occlusion in patients with dangerous placenta previa for cesarean section can effectively reduce the amount of intraoperative and postoperative blood loss,has no effect on the Apgar score of the newborn after birth,and does not increase the postoperative the occurrence of complications.

关 键 词：腹主动脉预置球囊 凶险性前置胎盘 剖宫产 母儿结局 

分 类 号：R714.46[医药卫生—妇产科学] R719[医药卫生—临床医学]