摘要
目的探讨腹主动脉球囊阻断术联合子宫动脉栓塞术对凶险性前置胎盘的临床疗效。方法选取2012年4月～2015年11月于我院就诊的69例凶险性前置胎盘伴植入患者作为研究对象,所有患者终止妊娠方法均为剖宫产手术。根据介入方法不同分为对照组(n=45例)和研究组(n=24例),其中对照组采用术后子宫动脉栓塞术,研究组采用术前腹主动脉球囊阻断术联合术后子宫动脉栓塞术。对比两组胎盘植入术中情况、术中输血量、出血量、手术时间、住院时间、子宫切除率、新生儿Apgar 1、5min评分、新生儿出生体重和并发症发生情况。结果两组胎盘植入术中所见类型如:穿透膀胱后壁、植入膀胱后壁、穿透肌层植入、部分肌层植入等比较差异无统计学意义(P>0.05)。研究组术中输血量、术中出血量及手术时间均明显低于对照组(P<0.05)。研究组住院时间明显短于对照组,子宫切除率明显低于对照组(P<0.05)。两组Apgar评分比较差异无统计学意义(t=1.774,P>0.05)。两组Apgar评分比较差异无统计学意义(t=1.502,P>0.05)。两组新生儿体重比较差异无统计学意义(t=1.356,P>0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论腹主动脉球囊阻断术联合子宫动脉栓塞术较单纯子宫动脉栓塞术有较低的子宫切除率,减少输血量及出血量,缩短手术时间和住院时间,可改善临床结局。
Objective To research the clinical efficacy of abdominal aortic balloon blockage combined with uterine artery embolization in the treatment of pernicious placenta previa.Methods 69 pernicious placenta previa patients between April 2012 and November 2015 of our hospital were selected.All of them were taken Cesarean section operation,and divided them into control group and research group by different intervention methods.The control group was treated by uterine artery embolization,while the research group was treated by abdominal aortic balloon blockage combined with uterine artery embolization.The condition of placental implantation,intraoperative transfusion,bleeding volume,operation duration,long of stay,hysterectomy rate,Apgar score of 1 minute and 5 minutes after birth,newborn birth weight and complications of two groups were observed.Results The condition of placental implantation,such as types of penetrates the posterior wall of the bladder,implant the posterior wall of the bladder,penetrating the muscular layer,partial myolayer implantation of two groups had no statistical difference(P>0.05).The intraoperative transfusion,bleeding volume and operation duration of research group were much lower than that of control group(P<0.05).The long of stay and the hysterectomy rate of research group were much lower than that of control group(P<0.05).The Apgar 1 min score of research group and the hysterectomy rate were 8.43±0.91 and 8.83±0.94(P>0.05).The Apgar 5 min score of research group and control group were 9.58±0.64 and9.64±0.61(P>0.05).The newborn birth weight of research group and control group were 2.63±0.24 and2.74±0.28 kg(P>0.05).Conclusion Abdominal aortic balloon blockage combined with uterine artery embolization has low hysterectomy rate,can reduced blood transfusion and bleeding volume,shorten operation duration and hospital stay,and improve clinical outcomes.
作者
钱敏
单楠
漆洪波
QIAN Min;SHAN Nan;QI Hongbo(Department of Obstetrics,The First Affiliated Hospital of Chongqing medical University,Chongqing 400010,China)
出处
《西部医学》
2018年第12期1758-1762,共5页
Medical Journal of West China
基金
国家自然科学基金青年基金(81601304)
国家自然科学基金重点国际合作项目(81520108013)
关键词
腹主动脉球囊阻断术
子宫动脉栓塞术
凶险性前置胎盘
出血
Abdominal aortic balloon blockage
Uterine artery embolization
Pernicious placenta previa
Bleeding
