不同性质球囊髂内动脉阻断术在凶险性前置胎盘剖宫产中的对比研究  

Internal iliac artery block using balloon of different properties in cesarean section for delivery female patients with pernicious placenta previa:a comparative study

作　　者：石静 谢军[1] 李琳娜[1] 李婷婷 孙平 刘洪波[2] 陈颍[2] SHI Jing;XIE Jun;LI Linna;LI Tingting;SUN Ping;LIU Hongbo;CHEN Ying(Department of Interventional Radiology,Fuyang Municipal People's Hospital,Fuyang,Anhui Province 236000,China)

机构地区：[1]阜阳市人民医院介入放射科,安徽阜阳236000 [2]阜阳市人民医院岳家湖院区急诊外科,安徽阜阳236000

出　　处：《介入放射学杂志》2024年第9期1009-1013,共5页Journal of Interventional Radiology

基　　金：中国红十字基金会医学赋能公益专项基金2023镇痛行动临床科研项目(CRCF-YXFN-202302105);中国红十字基金会医学赋能-领航精英科研项目(XM-HR-YXFN-2021-05-24)。

摘　　要：目的 比较不同性质球囊髂内动脉阻断术在凶险性前置胎盘(PPP)剖宫产中的应用效果。方法 回顾性分析82例PPP患者的临床资料,其中观察组40例,给予双侧髂内动脉顺应性Fogarty球囊阻断术;对照组42例,给予非顺应性球囊髂内动脉阻断术。比较两组患者在髂内动脉阻断术前、术后收缩压及心率、X线透视时间、胎儿体表辐射剂量、剖宫产时间、术中出血量及输血量、子宫动脉栓塞率、子宫切除率和1、5、10 min新生儿Apgar评分以及术后住院时间及手术相关并发症。结果 两组患者子宫均成功保留,均成功行双侧髂内动脉球囊阻断术辅助剖宫产手术顺利完成。撤出球囊导管,部分患者行子宫动脉栓塞术,无患者行卵巢动脉栓塞及子宫切除术。两组患者术前、术后收缩压和心率组间比较差异均无统计学意义,但两组术后收缩压、心率低于术前,均P<0.05。两组X线透视时间、胎儿体表辐射剂量、子宫动脉栓塞率、子宫切除率和1、5、10 min新生儿Apgar评分以及术后住院时间对比差异均无统计学意义,观察组剖宫产时间、术中出血量、术中输血量低于对照组,均P<0.05。两组患者球囊阻断术后其相关并发症发生率比较差异均无统计学意义。结论 不同性质髂内球囊动脉阻断术辅助在PPP剖宫产均安全有效,但双侧髂内动脉顺应性球囊阻断术在减少剖宫产手术时间、术中出血量、术中输血量等方面更具优势。Objective To compare the effect of internal iliac artery block using balloon of different properties in cesarean section for delivery female patients with pernicious placenta previa(PPP).MethodsThe clinical data of 82 delivery female patients with PPP were retrospectively analyzed.The patients were divided into observation group(n=40)and control group(n=42).The patients of the observation group received compliant Fogarty balloon block of bilateral internal iliac arteries,while the patients of the control group received non-compliant balloon block of bilateral internal iliac arteries.The preoperative and postoperative systolic blood pressure and heart rate,X-ray fluoroscopy time,fetal body surface radiation dose,time spent for cesarean section,intraoperative blood loss amount and blood transfusion quantity,uterine artery embolization rate,hysterectomy rate,1-,5-,and 10-minute neonatal Apgar scores,postoperative hospital stay,and surgery-related complications were compared between the two groups.Results In all patients of both groups,the uterus was successfully preserved and the bilateral internal iliac artery balloon obstruction-assisted cesarean section was successfully accomplished.After the balloon catheter was withdrawn,uterine artery embolization was carried out in some patients,and no patient received ovarian artery embolization and hysterectomy.No statistically significant differences in preoperative,postoperative systolic blood pressure and heart rate existed between the two groups,but in both groups the postoperative systolic blood pressure and heart rate were lower than their preoperative values(all P<0.05).No statistically significant differences in X-ray fluoroscopy time,fetal body surface radiation dose,uterine artery embolization rate,hysterectomy rate,1-,5-,and 10-minute neonatal Apgar scores,and postoperative hospital stay existed between the two groups.In the observation group the time spent for cesarean section,intraoperative blood loss amount and blood transfusion quantity were lower than those

关 键 词：球囊阻断 前置胎盘 胎盘植入 髂内动脉 剖宫产 子宫动脉栓塞术 

分 类 号：R714[医药卫生—妇产科学]