双侧髂内动脉球囊阻断术对凶险性前置胎盘并胎盘植入患者的疗效分析
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摘要
目的探讨双侧髂内动脉球囊阻断辅助下剖宫产术对凶险性前置胎盘并胎盘植入患者的影响。方法回顾性分析凶险性前置胎盘并胎盘植入87例患者的临床资料,根据术前是否行介入双侧髂内动脉临时球囊植入术,分为对照组(n=31例)和球囊组(n=56例)。比较两组术前高危因素、术中干预及出血情况、母婴并发症发生率等。结果两组患者术前一般资料、高危因素、术中干预及母婴并发症发生率等比较差异无统计学意义(P>0.05)。球囊组的出血量、B-lynch缝合的比例低于对照组(P<0.05)。对照组有1例行子宫切除术。球囊组中有1例发生血栓,予以灌注溶栓治疗。结论双侧髂内动脉球囊阻断辅助下剖宫产术减少了B-lynch缝合的使用、为术中充分止血、减少产后大出血有不可忽视作用。
引文
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[9] Dilauro MD,Dason S,Athreya S.Prophylactic balloon occlusion of internal iliac arteries in women with placenta accreta:literature review and analysis[J].Clin Radiol,2012,67(6):515-520.
[10] 王利民,罗丹,周辉,等.动脉序贯介入治疗对凶险型前置胎盘的疗效评价[J].现代妇产科进展,2015,24(11):823-827.
[11] 林靓,余艳红,杨茵,等.剖宫产术中宫腔填塞联合腹主动脉远端预置球囊阻断治疗植入型凶险型前置胎盘[J].中国微创外科杂,2014,14(7):608-611.
[2] Rosenberg T,Pariente G,Sergienko R,et al.Critical analysis of risk factors and outcome of placent a previa[J].Arch Gynecol Obstet,2011,284(1):47-51.
[3] Minas V,Gul N,Shaw E,et al.Prophylactic balloon occlusion of the common iliac arteries for the management of suspected placenta accreta/percreta:conclusions from a short case series[J].Arch Gynecol Obstet,2015,291(2):461-465.
[4] 彭方亮,罗欣,漆洪波.瘢痕子宫再次妊娠并发前置胎盘197例临床分析[J].中国实用妇科与产科杂志,2016,32(8):788-791.
[5] 蒋宇林,刘俊涛.穿透入膀胱的凶险型前置胎盘处理决策[J].中国实用妇科与产科杂志,2016,32(8):935- 938.
[6] Zangan SM,Funaki B,Lorenz JM,et al.Spontaneous antepartum hemorrhage while awaiting preoperative balloon occlusion for placenta percreta[J].Eur J Radiol Extra,2008,65(1):21-23.
[7] 翟敬芳,尹凤玲,张蓓,等.髂内动脉球囊封堵在凶险型前置胎盘剖宫产围手术期的临床应用[J].现代妇产科进展,2015,24(10):755-758
[8] Chen ZY,Li J,Shen J,et al.Direct puncture embolization of the internal iliac artery during cesarean delivery for pernicious placenta previa coexisting with placenta accreta[J].International Journal of Gynecology and Obstetrics,2016,135(3):264-267.
[9] Dilauro MD,Dason S,Athreya S.Prophylactic balloon occlusion of internal iliac arteries in women with placenta accreta:literature review and analysis[J].Clin Radiol,2012,67(6):515-520.
[10] 王利民,罗丹,周辉,等.动脉序贯介入治疗对凶险型前置胎盘的疗效评价[J].现代妇产科进展,2015,24(11):823-827.
[11] 林靓,余艳红,杨茵,等.剖宫产术中宫腔填塞联合腹主动脉远端预置球囊阻断治疗植入型凶险型前置胎盘[J].中国微创外科杂,2014,14(7):608-611.