Duan Xuhua, Chen Pengfei, Han Xinwei, Wang Yanli, Chen Zhimin, Zhang Xiaoli, Chu Qinjun, Liang Haomin
Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.
Department of Obstetrics, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.
J Obstet Gynaecol Res. 2018 Sep;44(9):1752-1760. doi: 10.1111/jog.13700. Epub 2018 Jul 5.
To compare the efficacy of cesarean section (CS) combined with intermittent aortic balloon occlusion with that of CS alone for treating patients with placenta previa complicated by placenta accreta.
Forty-five patients with placenta previa complicated by placenta accreta who underwent CS were retrospectively studied. Twenty-two patients had undergone CS combined with intermittent aortic balloon occlusion (combination group) and 23 patients received conventional hemostatic support only (control group). The postpartum hemorrhage, transfusion requirements, operation time and recovery time, and the ability to preserve the uterus and fertility were analyzed.
Intermittent aortic balloon occlusion significantly decreased the volume of blood loss in the combination group relative to the control group (597 ± 359 mL vs 2687 ± 575 mL; P < 0.001), and transfusion requirements were also reduced (498 ±195 mL vs 2390 ±789 mL; P <0.001). We observed shorter operation time in the combination group relative to the control group (63.8 ± 12.3 min vs 118.8 ± 22.4 min; P < 0.001), and fewer patients required uterine cavity stuffing followed by uterine artery embolization (n = 2 vs n = 10; P <0.05), uterine artery ligation (n = 1 vs n = 9; P < 0.05), and hysterectomy (n = 0 vs n =7; P < 0.05).
Intermittent aortic balloon occlusion may control postpartum hemorrhage in pregnancies complicated by placenta accreta, and improve the postoperative conditions.
比较剖宫产（CS）联合间歇性主动脉球囊阻断术与单纯剖宫产治疗前置胎盘合并胎盘植入患者的疗效。
回顾性研究45例接受剖宫产的前置胎盘合并胎盘植入患者。22例患者接受了剖宫产联合间歇性主动脉球囊阻断术（联合组），23例患者仅接受了传统止血支持（对照组）。分析产后出血、输血需求、手术时间和恢复时间，以及保留子宫和生育能力的情况。
与对照组相比，联合组间歇性主动脉球囊阻断术显著减少了失血量（597±359 mL对2687±575 mL；P<0.001），输血需求也减少了（498±195 mL对2390±789 mL；P<0.001）。我们观察到联合组的手术时间比对照组短（63.8±12.3分钟对118.8±22.4分钟；P<0.001），需要宫腔填塞加子宫动脉栓塞术（n=2对n=10；P<0.05）、子宫动脉结扎术（n=1对n=9；P<0.05）和子宫切除术（n=0对n=7；P<0.05）的患者更少。
间歇性主动脉球囊阻断术可能控制前置胎盘合并胎盘植入妊娠的产后出血，并改善术后情况。
