摘要
目的 分析不同预置球囊阻断术用于凶险性前置胎盘伴胎盘植入剖宫产者的效果。方法 方便选取2019年1月—2022年1月滨州市中心医院收治的80例凶险性前置胎盘伴胎盘植入患者为研究对象。按不同预置球囊阻断术将其分为A组(40例)和B组(40例),A组在剖宫产术前给予双侧髂内动脉预置球囊阻断术治疗,B组在剖宫产术前给予腹主动脉预置球囊阻断术治疗。比较两组临床相关指标、所受辐射剂量、透视时间、新生儿Apgar评分、子宫切除和膀胱损伤发生率、术后并发症发生率。结果 B组手术时间短于A组,术中出血量少于A组,球囊首次充盈阻断血流至子宫创面渗血增多所用时间久于对照组,差异均有统计学意义(P均<0.05)。两组住院时间比较,差异无统计学意义(P>0.05)。B组所受辐射剂量为(11.43±0.81)mGy,少于A组的(23.45±4.17)mGy,B组透视时间为(32.33±3.42)s,短于A组的(69.58±12.86)s,差异均有统计学意义(t=17.904,17.701;P均<0.05)。两组新生儿出生后1、5、10 min Apgar评分比较,差异均无统计学意义(P均>0.05)。B组子宫切除发生率为5.00%(2/40),低于A组的20.00%(8/40),差异有统计学意义(χ^(2)=4.114,P<0.05)。两组膀胱损伤发生率及术后并发症总发生率比较,差异均无统计学意义(P均>0.05)。结论 对于凶险性前置胎盘伴胎盘植入行剖宫产的患者而言,在球囊技术中选用腹主动脉预置球囊阻断术具有显著的整体优势,其优势主要体现为减少术中的出血量、缩短手术时间、降低术中子宫切除情况的发生风险,还可降低辐射量,具备较高的安全性。
Objective To analyze the efficacy of different preset balloon occlusion techniques in cesarean section for patients with pernicious placenta previa complicated with placenta accreta.Methods Eighty patients with pernicious placenta previa complicated with placenta accreta admitted to Binzhou Central Hospital from January 2019 to January 2022 were conveniently selected as the research objects.They were divided into group A(forty cases)and group B(forty cases)according to different preset balloon occlusion techniques.Group A was treated with bilateral internal iliac artery preset balloon occlusion before cesarean section,while group B was treated with abdominal aorta preset balloon occlusion before cesarean section.The clinical related indicators,received radiation dose,fluoroscopy time,neonatal Apgar scores,incidence of hysterectomy and bladder injury,and incidence of postoperative complications were compared between the two groups.Results The operation time of group B was shorter than that of group A,the intraoperative blood loss was less than that of group A,and the time from the first inflation of the balloon to block blood flow to the increase of bleeding from the uterine wound was longer than that of group A,differences were statistically significant(all P<0.05).There was no statistically significant difference in the length of hospital stay between the two groups(P>0.05).The radiation dose received by group B was(11.43±0.81)mGy,which was less than(23.45±4.17)mGy of group A,the fluoroscopy time of group B was(32.33±3.42)s,which was shorter than(69.58±12.86)s of group A,differences were statistically significant(t=17.904,17.701;all P<0.05).There were no statistically significant differences in the Apgar scores of neonates at 1,5,and 10 minutes after birth between the two groups(all P>0.05).The incidence of hysterectomy in group B was 5.00%(2/40),which was lower than 20.00%(8/40)in group A,difference was statistically significant(χ^(2)=4.114,P<0.05).There were no statistically significant differences in the incidence of bladder injury and the total incidence of postoperative complications between the two groups(all P>0.05).Conclusion For patients with pernicious placenta previa complicated with placenta accreta undergoing cesarean section,the selection of abdominal aorta preset balloon occlusion in balloon technology has significant overall advantages.Its advantages are mainly reflected in reducing intraoperative blood loss,shortening the operation time,reduce the risk of intraoperative hysterectomy,reducing radiation dose,and having high safety.
作者
寇明捷
王佃卫
张花梅
KOU Mingjie;WANG Dianwei;ZHANG Huamei(Department of Obstetrics,Binzhou Central Hospital,Binzhou 251700,Shandong,China)
出处
《系统医学》
2025年第21期139-143,156,共6页
Systems Medicine
关键词
凶险性前置胎盘
胎盘植入
预置球囊阻断术
并发症
Pernicious placenta praevia
Placenta accreta
Preset balloon occlusion techniques
Complication
