Chen Zhenyu, Li Ju, Shen Jian, Jin Jiaxi, Zhang Wei, Zhong Wan
Department of Obstetrics and Gynaecology, No. 202 People's Liberation Army Hospital, Shenyang, China.
Department of Obstetrics and Gynaecology, No. 202 People's Liberation Army Hospital, Shenyang, China.
Int J Gynaecol Obstet. 2016 Dec;135(3):264-267. doi: 10.1016/j.ijgo.2016.05.018. Epub 2016 Aug 21.
To evaluate direct puncture embolization of the internal iliac artery with hemostatic gelatin sponge particles to treat pernicious placenta previa coexisting with placenta accreta during cesarean delivery.
A retrospective study was conducted of data from women with pernicious placenta previa and placenta accreta who underwent direct puncture embolization of the internal iliac artery during cesarean delivery at a center in China between September 1, 2013, and February 28, 2015. Information regarding surgical procedures, operative data, and outcomes during hospitalization were obtained from medical records.
The procedure was successful in all 16 cases included. Mean operative time was 78 minutes (range 65-90) and mean estimated blood loss was 1550 mL (range 1000-2500). Complications such as fever, buttock pain, or acute limb ischemia were not observed. The procedure was performed after partial cystectomy for two patients with bladder invasion. Postoperative Doppler imaging indicated uterine recovery and normalized uterine blood flow in all patients.
Direct puncture embolization of the internal iliac artery during cesarean delivery was a safe, effective, simple, and rapid method to control hemorrhage among women with pernicious placenta previa and placenta accreta.
评估剖宫产术中使用止血明胶海绵颗粒对髂内动脉进行直接穿刺栓塞术治疗凶险性前置胎盘合并胎盘植入的效果。
回顾性研究2013年9月1日至2015年2月28日在中国某中心行剖宫产术时对凶险性前置胎盘合并胎盘植入患者进行髂内动脉直接穿刺栓塞术的女性患者资料。从病历中获取手术操作、手术数据及住院期间结局等信息。
纳入的16例患者手术均成功。平均手术时间为78分钟（范围65 - 90分钟），平均估计失血量为1550毫升（范围1000 - 2500毫升）。未观察到发热、臀部疼痛或急性肢体缺血等并发症。2例膀胱受侵患者在部分膀胱切除术后进行了该手术。术后多普勒成像显示所有患者子宫恢复且子宫血流正常。
剖宫产术中对髂内动脉进行直接穿刺栓塞术是控制凶险性前置胎盘合并胎盘植入女性出血的一种安全、有效、简单且快速的方法。
