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子宫动脉栓塞术在腹主动脉球囊阻断后胎盘植入谱系患者中的应用。

Application of Uterine Artery Embolization in Patients With Placenta Accreta Spectrum After Abdominal Aortic Balloon Occlusion.

机构信息

Department of Obstetrics, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Vasc Endovascular Surg. 2024 Jul;58(5):498-504. doi: 10.1177/15385744241229596. Epub 2024 Jan 22.

Abstract

OBJECTIVE

To evaluate the application of different uterine artery embolization procedures under balloon occlusion of the abdominal aorta in patients with Placenta Accreta Spectrum (PAS) undergoing cesarean section.

MATERIALS AND METHODS

A retrospective analysis was performed on clinical data from 72 patients who underwent uterine artery embolization for hemostasis during cesarean section with PAS. The patients were divided into two groups according to the embolization method used during surgery: group A (n = 43) underwent uterine artery embolization by withdrawing the balloon and inserting a Cobra catheter into the uterine artery for embolization, while group B (n = 29) underwent uterine artery embolization with a Cobra catheter inserted via contralateral puncture of the femoral artery and balloon occlusion. General information, surgical data, and postoperative recovery were compared between the 2 groups.

RESULTS

The bleeding and transfusion volumes were lower in group B than in group A and the differences between the 2 groups were statistically significant. There were no significant differences in surgical duration, number of embolized vessels, length of hospital stay, postoperative complications, or menstrual recovery between the 2 groups.

CONCLUSION

For patients with PAS undergoing cesarean section, uterine artery embolization for hemostasis is preferably performed by inserting a Cobra catheter via contralateral puncture of the femoral artery under abdominal aortic balloon occlusion.

摘要

目的

评估腹主动脉球囊阻断下经不同子宫动脉栓塞术在剖宫产术中胎盘植入谱系(PAS)患者中的应用。

材料与方法

回顾性分析 72 例行剖宫产术伴 PAS 行子宫动脉栓塞术止血的患者的临床资料。根据术中使用的栓塞方法将患者分为两组:A 组(n=43)采用撤球并将 Cobra 导管插入子宫动脉栓塞的方法,B 组(n=29)采用经对侧股动脉穿刺并球囊阻断后插入 Cobra 导管的方法。比较两组的一般信息、手术数据和术后恢复情况。

结果

B 组的出血量和输血量均低于 A 组,两组差异有统计学意义。两组手术时间、栓塞血管数、住院时间、术后并发症和月经恢复情况无显著差异。

结论

对于行剖宫产术的 PAS 患者,腹主动脉球囊阻断下经对侧股动脉穿刺插入 Cobra 导管行子宫动脉栓塞术止血较为理想。

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