摘要
目的探讨髂内动脉栓塞术联合剖宫产术对凶险性前置胎盘并大出血产妇围手术期指标及术后并发症的影响。方法回顾性选取2019年1月至2021年1月收治的凶险性前置胎盘并大出血患者44例作研究对象,按治疗方式分为传统手术组21例,介入栓塞组23例。传统手术组行剖宫产术治疗,介入栓塞组实施髂内动脉栓塞术联合剖宫产术。检测并比较两组手术时间、术中出血量、住院时间、术后血β-hCG恢复正常时间、术后阴道流血时间、新生儿Apgar评分、术后不良事件发生率等。结果介入栓塞组的手术时间、术中出血量、住院时间、术后血β-hCG恢复正常时间、术后阴道流血时间、疼痛持续时间为(53.24±7.85)min、(623.34±143.56)mL、(7.10±1.24)d、(15.42±1.35)d、(2.12±0.58)d、(3.25±0.86)d,均低于传统手术组[(85.37±21.45)min、(923.42±224.56)mL、(10.56±0.56)d、(25.41±6.54)d、(5.62±1.01)d、(6.23±2.47)d],差异均有统计学意义(P<0.05)。两组患儿出生后1、5、10 min的Apgar评分比较差异无统计学意义(P>0.05)。介入栓塞组的疼痛、发热、切口感染等术后并发症发生率为47.83%、21.74%、0,均显著低于传统手术组(85.71%、71.43%、14.29%),差异均有统计学意义(P<0.05)。介入栓塞组手术成功率、栓塞后出血立即停止率为100.00%、95.65%,显著高于传统手术组(85.71%、80.95%),差异均有统计学意义(P<0.05)。结论髂内动脉栓塞术联合剖宫产术可有效改善凶险性前置胎盘并大出血患者围手术期指标,降低并发症发生风险,提升手术成功率,值得临床推广应用。
Objective To investigate the effect of internal iliac artery embolization combined with cesarean section on perioperative indexes and postoperative complications of dangerous placenta previa and massive hemorrhage.Methods This paper was a retrospective study.A total of 44 patients with dangerous placenta previa and massive hemorrhage who were admitted from January 2019 to January 2021 were selected as the research subjects,and they were voluntarily divided into the control group of 21 cases and the observation group of 23 cases.The control group was treated with bilateral uterine artery interventional angiography and embolization,and the observation group was treated with digital subtraction angiography(DSA)-guided right femoral artery puncture and balloon catheter placement on the basis of the control group.The operation time,intraoperative blood loss,hospital stay,postoperative bloodβ-hCG recovery time,postoperative vaginal bleeding time,neonatal Apgar score,and postoperative adverse events were detected and compared between the two groups.Results The operation time,intraoperative bleeding volume,postoperative bloodβ-hCG recovery time,postoperative vaginal bleeding time,hospital stay,and pain duration in the interventional embolization group were(53.24±7.85)min,(623.34±143.56)mL,(7.10±1.24)d,(15.42±1.35)d,(2.12±0.58)d,(3.25±0.86)d,which were lower than those in the traditional operation group[(85.37±21.45)min,(923.42±224.56)mL,(10.56±0.56)d,(25.41±6.54)d,(5.62±1.01)d,(6.23±2.47)d],and the differences were statistically significant(P<0.05).There was no difference in Apgar score at 1,5 and 10 min after birth between the interventional embolization group and the traditional surgery group(P>0.05).The incidence of postoperative complications such as pain,fever and incision infection in the interventional embolization group was 47.83%,21.74%and 0,which were significantly lower than those in the traditional operation group(85.71%,71.43%and 14.29%),and the difference was statistically significant(P<0.05).
作者
习开超
高丽丽
曹淑新
张洪莉
张素萍
佟雪
XI Kai-chao;GAO Li-li;CAO Shu-xin(Department of Operating Room,Tangshan Maternal and Child Health Hospital,Tangshan Hebei 063000,China;Department of Obstetrics and Gynecology,Tangshan Maternal and Child Health Hospital,Tangshan Hebei 063000,China)
出处
《临床和实验医学杂志》
2023年第5期525-528,共4页
Journal of Clinical and Experimental Medicine
基金
河北省2020年度医学科学研究课题计划项目(编号:20201488)。
关键词
髂内动脉栓塞术
剖宫产术
风险管理
凶险性前置胎盘
大出血
Internal iliac artery embolization
Cesarean section
Risk management
Dangerous placenta previa
Massive bleeding
