腹主动脉球囊阻断术联合子宫下段压迫缩窄缝合术治疗凶险性前置胎盘致产后出血患者的效果  

Effects of abdominal aortic balloon occlusion combined with lower uterine segment compression constriction suture in treatment of postpartum hemorrhage caused by pernicious placenta previa

作　　者：杨晓华 YANG Xiaohua(Department of Obstetrics and Gynecology of Rehabilitation Hospital of Xuchang Central Hospital,Xuchang 461000 Henan,China)

机构地区：[1]许昌市中心医院康复医院妇产科,河南许昌461000

出　　处：《中国民康医学》2023年第11期51-54,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察腹主动脉球囊阻断术联合子宫下段压迫缩窄缝合术治疗凶险性前置胎盘(PPP)致产后出血(PPH)患者的效果。方法:回顾性分析2018年7月至2022年2月该院收治的114例PPP致PPH患者的临床资料,根据治疗方法不同分为观察组(n=58)与对照组(n=56)。观察组采用腹主动脉球囊阻断术联合子宫下段压迫缩窄缝合术治疗,对照组采用子宫下段压迫缩窄缝合术治疗。比较两组止血总有效率、手术相关指标[手术时间、术中出血量、术后24 h出血量、止血起效时间]水平、手术前后凝血指标[凝血因子Ⅷ、凝血因子Ⅸ、血管紧张素Ⅱ(AngⅡ)]水平、输血率、新生儿窒息率、子宫摘除率、并发症发生率和术后宫缩压力。结果:观察组止血总有效率显著高于对照组,差异有统计学意义(P<0.05);观察组手术时间、止血起效时间短于对照组,术中出血量、术后24 h出血量少于对照组,差异有统计学意义(P<0.05);术后24 h,两组凝血因子Ⅷ、凝血因子Ⅸ、AngⅡ水平均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05);两组输血率、新生儿窒息率、并发症发生率比较,差异均无统计学意义(P>0.05);观察组子宫摘除率低于对照组,差异有统计学意义(P<0.05);术后30、60 min,观察组宫缩压力均高于对照组,差异有统计学意义(P<0.05)。结论:腹主动脉球囊阻断术联合子宫下段压迫缩窄缝合术治疗PPP致PPH患者可提高止血总有效率、凝血指标水平和宫缩压力,降低手术相关指标水平和子宫摘除率,优于单纯子宫下段压迫缩窄缝合术治疗效果。Objective:To observe effects of abdominal aortic balloon occlusion combined with lower uterine segment compression constriction suture in treatment of postpartum hemorrhage(PPH)caused by pernicious placenta previa(PPP).Methods:The clinical data of 114 patients with PPH caused by PPP admitted to the hospital from July 2018 to February 2022 were retrospectively analyzed.According to different treatment methods,they were divided into observation group(n=58)and control group(n=56).The observation group was treated with abdominal aortic balloon occlusion combined with lower uterine segment compression constriction suture,while the control group was treated with lower uterine segment compression constriction suture.The hemostatic efficacy,the operation-related index levels[operation time,intraoperative blood loss,postoperative 24 h blood loss,hemostatic onset time],the coagulation index levels[coagulation factor VIII,coagulation factor IX,angiotensin II(Ang II)]before and after the surgery,the blood transfusion rate,the neonatal asphyxia rate,the uterine removal rate,the complication rate,and the postoperative uterine contraction pressure level were compared between the two groups.Results:The total effective rate of hemostasis in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).The operation time and the hemostasis onset time in the observation group were shorter than those in the control group;the intraoperative blood loss and postoperative 24 h blood loss were lower than those in the control group;and the differences were statistically significant(P<0.05).24 h after the surgery,the levels of coagulation factor VIII,coagulation factor IX and Ang II in the two groups were higher than those before the surgery,those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the blood transfusion rate,the neonatal asphyxia rate a

关 键 词：产后出血 凶险性前置胎盘 腹主动脉球囊阻断术 宫缩压力 输血率 子宫摘除率 

分 类 号：R719[医药卫生—妇产科学]