Wei L C, Gong G Y, Chen J H, Hou P Y, Li Q Y, Zheng Z Y, Su Y M, Zheng Y, Luo C Z, Zhang K, Xu T F, Ye Y H, Lan Y J, Wei X M
Department of Vascular Interventional Surgery, Liuzhou Workers Hospital, Liuzhou 545005, China.
Zhonghua Yi Xue Za Zhi. 2018 Mar 27;98(12):930-934. doi: 10.3760/cma.j.issn.0376-2491.2018.12.011.
To discuss the feasibility, effect and safety of lower abdominal aorta balloon occlusion technique by ultrasound guiding during caesarean section in patients with pernicious placenta previa. The clinical data of 40 patients with pernicious placenta previa complicated with placenta accreta from January 2015 to August 2017 in Liuzhou workers hospital were analyzed retrospectively. The study group included 20 cases, which were operated in the way of cesarean section combined lower abdominal aorta balloon occlusion technique by ultrasound guiding, while the control group also included 20 cases, which were operated in the way of the conventional cesarean section without balloon occlusion technique. The bleeding amount, blood transfusion volume, operative total time, hysterectomy and complications of the two groups were compared. The bleeding amount and blood transfusion volume in study group were(850±100)ml and (400±50)ml, which were lower than that of the control group[(2 500±230)ml and (1 500±100)ml], the difference was statistically significant(=35.624, 16.523, all <0.05). In addition, the hysterectomy rate in study group was 5%, which was lower than that in the control group(30%), the difference was statistically significant(χ=8.672, <0.05). And the total time of operation was (2.0±0.5)h in the study group, which was shorter than that in the control group[(3.5±0.4)h]. The difference was statistically significant(=11.362, <0.05). No postoperative complications took place in the study group.The blood pressure, heart rate and blood oxygen fluctuated significantly, and the postoperative renal function was significantly reduced in the control group. The lower abdominal aorta balloon occlusion technique by ultrasound guiding during a caesarean section in patients with pernicious placenta previa can effectively control the bleeding during operation, and preserve reproductive function to the utmost degree.Therefore, the technique is safe, feasible, convenient and cheaper, and worthy of being widely applied in clinic.
探讨超声引导下低位腹主动脉球囊阻断技术在凶险性前置胎盘剖宫产术中的可行性、效果及安全性。回顾性分析2015年1月至2017年8月柳州市工人医院收治的40例凶险性前置胎盘合并胎盘植入患者的临床资料。研究组20例，采用超声引导下剖宫产联合低位腹主动脉球囊阻断技术手术；对照组20例，采用传统剖宫产未行球囊阻断技术手术。比较两组术中出血量、输血量、手术总时间、子宫切除情况及并发症发生情况。研究组术中出血量及输血量分别为（850±100）ml和（400±50）ml，低于对照组的（2 500±230）ml和（1 500±100）ml，差异有统计学意义（t=35.624、16.523，均<0.05）。此外，研究组子宫切除率为5%，低于对照组的30%，差异有统计学意义（χ²=8.672，<0.05）。研究组手术总时间为（2.0±0.5）h，短于对照组的（3.5±0.4）h，差异有统计学意义（t=11.362，<0.05）。研究组术后无并发症发生，对照组血压、心率、血氧波动明显，术后肾功能明显下降。超声引导下低位腹主动脉球囊阻断技术应用于凶险性前置胎盘剖宫产术，可有效控制术中出血，最大程度保留生殖功能。该技术安全、可行、便捷、费用低，值得临床广泛应用。
