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山东大学学报（医学版） ›› 2016, Vol. 54 ›› Issue (9): 22-25.doi: 10.6040/j.issn.1671-7554.0.2016.548

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腹主动脉球囊阻断术在凶险性前置胎盘并胎盘植入剖宫产术中的应用

李继军1,左常婷2,王谢桐2,尚建强1   

  1. 1.山东省医学影像学研究所介入放射学研究室, 山东 济南 250021;2.山东大学附属省立医院妇产科, 山东 济南 250021
  • 收稿日期:2016-05-16 出版日期:2016-09-10 发布日期:2016-09-10
  • 通讯作者: 尚建强. E-mail:yysljj@sina.com E-mail:yysljj@sina.com
  • 基金资助:
    山东省科技发展计划(2014GSF118088);山东省自然科技基金(ZR2013HM067)

Application of abdominal aorta balloon occlusion in cesarean section for patients with pernicious placenta previa complicated by placenta accreta

LI Jijun1, ZUO Changting2, WANG Xietong2, SHANG Jianqiang1   

  1. 1. Department of Interventional Radiology, Shandong Medical Imaging Research Institute, Jinan 250021, Shandong, China;
    2. Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China
  • Received:2016-05-16 Online:2016-09-10 Published:2016-09-10

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摘要： 目的 探讨腹主动脉球囊阻断术在凶险性前置胎盘并胎盘植入患者剖宫产术中的临床应用。 方法 回顾分析65例凶险性前置胎盘并胎盘植入患者的临床资料。全部患者均于剖宫产术前在介入室行股动脉插管并送入球囊导管,球囊放置于腹主动脉下段,手术中充盈球囊临时阻断主动脉血流。记录剖宫产术中出血量、子宫切除例数、孕妇接受射线剂量。 结果 手术中出血量200~4 500 mL,平均1 520 mL;术中、术后输红细胞0~3 600 mL,平均1 040 mL;无产妇及胎儿死亡及严重并发症。7例行子宫切除术(10.8%)。 结论 腹主动脉球囊阻断术可有效控制凶险性前置胎盘剖宫产术中出血、减少子宫切除率,辐射剂量对胎儿安全。但风险不可忽视,应严格掌握适应证。

关键词: 腹主动脉阻断, 凶险性前置胎盘, 剖宫产, 胎盘植入

Abstract: Objective To explore the clinical application of abdominal aorta balloon occlusion in cesarean section for patients with pernicious placenta previa(PPP). Methods The clinical data of 65 consecutive cases of PPP complicated with placenta accreta were retrospectively analyzed. Prophylactic abdominal aortic occlusion balloon catheter was placed transfemorally in the angiography room before surgery. Abdominal aorta occlusion was performed during the cesarean deliveries. The incidence of hysterectomia, estimated blood loss, number of transfused units of red blood cells and maternal radiation dose were recorded. Results The volume of bleeding was 200-4 500 mL(mean 1 520 mL), and transfused red blood cells was 0-3 600 mL(mean 1 040 mL). Hysterectomy was performed in 7 cases(10.8%). No serious materna1 and infant complications occurred during and after the surgery. Conclusion Balloon occlusion of the abdominal aorta in cesarean section seems to be safe and effective in controlling bleeding and risks of hysterectomia. The radiation exposure is safe to infants. However, patients should be selected strictly according to the operative indications to avoid risks of complications.

Key words: Pernicious placenta previa, Placenta implantation, Abdominal aorta occlusion, Cesarean section

中图分类号: 

  • R816.4
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