摘要
目的:分析在完全性前置胎盘剖宫产术中使用双侧髂内动脉球囊阻断术的安全性及有效性。方法:将2017年1月至2020年12月在大理市第一人民医院确诊为完全性前置胎盘患者纳入研究,对其行髂内动脉球囊预置术、剖宫产术,详细观察并记录患者术中出血量、介入手术时间、新生儿体质量、新生儿Apgar评分、新生儿窒息率和住院时间等指标。结果:所有患者均为中央型前置胎盘,在球囊临时阻断辅助下均顺利实施剖宫产手术,其中1例患者伴穿透性胎盘植入,因止血困难选择行子宫次全切除术。所有新生儿健康存活,所有患者术后未发生感染,未出现下肢深静脉血栓、髂内动脉血栓,未发生动脉破裂、器官损伤和孕产妇死亡等并发症,均顺利出院。结论:对于怀疑有凶险性完全性前置胎盘的孕妇,采用基于多学科急救团队的管理模式来制定详细方案,在严格掌握手术适应证的前提下,在剖宫产术前预置球囊为治疗完全性前置胎盘患者提供了一种新的选择,具有出血量少、并发症少等优点,同时可保留子宫,提高患者术后生活质量。
Objective:To analyze the safety and effectiveness of bilateral internal iliac artery balloon occlusion in cesarean section of complete placenta previa.Methods:The patients with complete placenta previa diagnosed in No.1 People's Hospital of Dali City from January 2017 to December 2020 were included in the study.Preoperative internal iliac artery balloon occlusion was performed,followed by cesarean section.The intraoperative blood loss,intervention time,neonatal weight,neonatal Apgar score,neonatal asphyxia rate,and hospitalization time were observed and recorded in detail.Results:All patients had central placenta previa,and cesarean section was successfully performed with the assistance of temporary balloon occlusion.One patient had penetrating placenta implantation,and underwent subtotal hysterectomy due to hemostasis difficulties.All newborns survived,and no infections,deep venous thrombosis,iliac artery thrombosis,arterial rupture,organ damage,or maternal deaths occurred postoperatively.Conclusion:For pregnant women suspected of having dangerous complete placenta previa,a detailed treatment plan based on a multidisciplinary emergency team should be developed.Temporary balloon occlusion before cesarean section provides a safe and effective method for treating complete placenta previa with less bleeding and fewer complications while preserving the uterus,improving the patient's postoperative quality of life.
作者
杨思丽
罗万训
王建萍
Yang Sili;Luo Wanxun;Wang Jianping(Department of Obstetrics,No.1 People's Hospital of Dali City,Dali,Yunnan 671000,China)
出处
《大理大学学报》
2023年第4期60-63,共4页
Journal of Dali University
关键词
完全性前置胎盘
髂内动脉球囊阻断术
剖宫产
complete placenta previa
balloon occlusion of internal iliac artery
cesarean section
