[1]刘智勇,余 雷,易小宇,等.球囊阻断腹主动脉控制凶险性前置胎盘并胎盘植入剖宫产术中出血22例[J].介入放射学杂志,2016,(07):624-627.
　LIU Zhi-yong,YU Lei,YI Xiao-yu,et al.The occlusion of abdominal aorta with balloon to control bleeding during operation for dangerous placenta previa associated with placenta accrete: preliminary results in 22 cases [J].journal interventional radiology,2016,(07):624-627.
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球囊阻断腹主动脉控制凶险性前置胎盘并胎盘植入剖宫产术中出血22例 ()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2016年07期
页码:
624-627
栏目:
临床研究
出版日期:
2016-07-25

文章信息/Info

Title:
The occlusion of abdominal aorta with balloon to control bleeding during operation for dangerous placenta previa associated with placenta accrete: preliminary results in 22 cases

作者:
刘智勇;  余 雷;  易小宇;  韦小芳
Author(s):
LIU Zhi-yong;  YU Lei;  YI Xiao-yu;  WEI Xiao-fang
Department of General Interventional Radiology, Peoples Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Autonomous Region 530021, China
关键词:
【关键词】 腹主动脉阻断;  球囊导管;  凶险性前置胎盘;  胎盘植入
文献标志码:
A
摘要:
【摘要】 目的 应用球囊导管阻断腹主动脉后再行胎盘的剥离，探讨其对减少凶险性前置胎盘并胎盘植入的剖宫产术中出血的临床意义。方法回顾性分析22例凶险性前置胎盘并胎盘植入的剖宫产患者。所有患者均接受术前放置球囊导管，凶险性前置胎盘剖宫产术中先娩出胎儿，断脐后立即给予球囊阻断。结果 所有患者均证实为凶险性前置胎盘并胎盘植入，包括3例穿透性胎盘植入患者。该方法的技术成功率为86.3％（19/22）。19例患者成功接受手术并保留子宫。子宫切除率约13.7%（3/22）。术中出血量为（686±355） ml。22例患者中仅3例穿透性胎盘植入的患者术中输血，其余19例患者均未输血，术中球囊阻断时间以及胎儿的辐射剂量分别为（25.4±7.2） min和（30.2±8.9） mGy。术后和随访期间并无介入相关的并发症。结论 腹主动脉球囊阻断术能够有效控制凶险性前置胎盘并胎盘植入患者胎盘剥离时引起的术中大出血，降低输血需求及子宫切除率。

参考文献/References:

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［2］ Young BC, Nadel A, Kaimal A. Does previa location matter? Surgical morbidity associated with location of a placenta previa［J］. J Perinatol, 2014, 34: 264-267.

［3］ Cali G, Forlani F, Giambanco L, et al. Prophylactic use of intravasular balloon catheters in women with placenta accreta, increta and percreta［J］. Eur J Obstet Gynecol Reprod Biol, 2014, 179: 36-41

［4］ Soyer P, Morel O, Fargeaudou Y, et al. Value of pelvic embolization in the management of severe postpartum hemorrhage due to placenta accreta, increta or percreta［J］. Eur J Radiol, 2011, 80: 729-735.

［5］ Bodner LJ, Nosher JL, Gribbin C, et al. Balloon-assisted occlusion of the internal iliac arteries in patients with placenta accrete/percreta［J］. Cardiovasc Intervent Radiol 2006; 29: 354-361.

［6］ Shrivastava V, Nageotte M, Major C, et al. Case-control comparison of cesarean hysterectomy with and without prophylactic placement of intravascular balloon catheters for placenta accreta［J］. Am J Obstet Gynecol, 2007, 197: 402.e1-e5.

［7］ Panici PB, Anceschi M, Borgia ML, et al. Intraoperative aorta balloon occlusion: fertility preservation in patients with placenta previa accreta/increta［J］. J Matern Fetal Neonatal Med 2012, 25: 2512-2516.

［8］ Duan XH, Wang YL, Han XW, et al. Caesarean section combined with temporary aortic balloon occlusion followed by uterine artery embolisation for the management of placenta accrete［J］. Clin Radiol, 2015, 70: 932-937.

［9］ 杨厚林， 唐 仪， 方主亭， 等. 腹主动脉阻断联合子宫动脉栓塞在九例前置胎盘并胎盘植入剖宫产手术中的应用［J］. 介入放射学杂志, 2013, 22, 1036-1038.

［10］Thabet A, Kalva SP, Liu B, et al. Interventional radiology in pregnancy complications: indications, technique, and methodsfor minimizing radiation exposure［J］. Radiographics, 2012, 32: 255-274.

［11］王艳丽， 段旭华， 韩新魏, 等. 球囊暂时封堵堵腹主动脉在凶险性前置胎盘并胎盘植入剖宫产中的应用［J］. 实用放射学杂志， 2015, 31： 1186-1197.

 

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备注/Memo

备注/Memo:
（收稿日期：2016-01-15）

（本文编辑：俞瑞纲）
更新日期/Last Update: 2016-07-18