[1]张 伟.前置胎盘剖宫产术中髂内动脉栓塞与低位腹主动脉球囊阻断比较研究 [J].介入放射学杂志,2018,27(04):322-326.
 ZHANG Wei.Internal iliac artery embolization vs lower abdominal aortic balloon occlusion in cesarean section for delivery women with placenta previa: a comparative study[J].journal interventional radiology,2018,27(04):322-326.
点击复制

前置胎盘剖宫产术中髂内动脉栓塞与低位腹主动脉球囊阻断比较研究 

()

PDF下载中关闭

分享到:

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

卷:
27
期数:
2018年04期
页码:
322-326
栏目:
血管介入
出版日期:
2018-04-25

文章信息/Info

Title:
Internal iliac artery embolization vs lower abdominal aortic balloon occlusion in cesarean section for delivery women with placenta previa: a comparative study
作者:
张 伟
Author(s):
ZHANG Wei
Department of Interventional Radiology, Zhengzhou Municipal First People’s Hospital, Zhengzhou, Henan Province 450004, China
关键词:
【关键词】 前置胎盘 栓塞 球囊阻断 剖宫产
文献标志码:
A
摘要:
【摘要】 目的 对比研究前置胎盘剖宫产术中髂内动脉栓塞(IIAE)与低位腹主动脉球囊阻断控制产后出血的效果及安全性。方法 回顾性分析2011年12月至2017年3月接受介入治疗的连续44例前置胎盘产妇临床资料,其中23例行IIAE(栓塞组),21例行低位腹主动脉球囊阻断(球囊阻断组)。观察比较两组患者术中、术后及新生儿情况。结果 与栓塞组相比,球囊阻断组术中出血量更少[(619.05±479.19) mL对(1 045.45±694.79) mL,P<0.05],剖宫产时间更短[(88.48±26.80) min对(121.67±40.46) min,P<0.05],X线曝光时间更短[(26.38±6.45) s对(145.71±40.56) s,P<0.05],X线剂量更少[(5.72±1.45) mGy对(26.49±5.87) mGy,P<0.05];两组术后住院时间、输血率、子宫切除率、术后活动性出血、新生儿Apgar评分及体重间差异均无统计学意义(P>0.05)。两组均无严重并发症发生。结论 IIAE和低位腹主动脉球囊阻断在前置胎盘剖宫产术中控制出血均安全有效。低位腹主动脉球囊阻断与IIAE相比,在减少术中出血量、缩短剖宫产时间、减少X线曝光时间及剂量方面更有优势。

参考文献/References:

[1] 中华医学会妇产科学分会产科学组. 前置胎盘的临床诊断与处理指南[J]. 中华妇产科杂志, 2013, 48: 148- 150.
[2] O’Brien D, Babiker E, O’Sullivan O, et al. Prediction of peripartum hysterectomy and end organ dysfunction in major obstetric haemorrhage[J]. Eur J Obstet Gynecol Reprod Biol, 2010, 153: 165- 169.
[3] Brace V, Kernaghan D, Penney G. Learning from adverse clinical outcomes: major obstetric haemorrhage in Scotland, 2003- 05[J]. BJOG, 2007, 114: 1388- 1396.
[4] Mercier FJ, Van de Velde M. Major obstetric hemorrhage[J]. Anesthesiol Clin, 2008, 26: 53- 66.
[5] Brown BJ, Heaston DK, Poulson AM, et al. Uncontrollable postpartum bleeding: a new approach to hemostasis through angiographic arterial embolization[J]. Obstet Gynecol, 1979, 54: 361- 365.
[6] Rebonato A, Mosca S, Fischer M, et al. Endovascular management of massive post- partum haemorrhage in abnormal placental implantation deliveries[J]. Eur Radiol, 2016, 26: 1620- 1630.
[7] Li Q, Yang ZQ, Mohammed W, et al. Prophylactic uterine artery embolization assisted cesarean section for the prevention of intrapartum hemorrhage in high- risk patients[J]. Cardiovasc Intervent Radiol, 2014, 37: 1458- 1463.
[8] Pan Y, Zhou X, Yang Z, et al. Retrospective cohort study of prophylactic intraoperative uterine artery embolization for abnormally invasive placenta[J]. Int J Gynaecol Obstet, 2017, 137: 45- 50.
[9] Chen Z, 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]. Int J Gynaecol Obstet, 2016, 135: 264- 267.
[10] Paull JD, Smith J, Williams L, et al. Balloon occlusion of the abdominal aorta during caesarean hysterectomy for placenta percreta[J]. Anaesth Intens Care, 1995, 23: 731- 734.
[11] Cui S, Zhi Y, Cheng G, et al. Retrospective analysis of placenta previa with abnormal placentation with and without prophylactic use of abdominal aorta balloon occlusion[J]. Int J Gynaecol Obstet, 2017, 137: 265- 270.
[12] Chen M, Xie L. Clinical evaluation of balloon occlusion of the lower abdominal aorta in patients with placenta previa and previous cesarean section: aretrospective study on 43 cases[J]. Int J Surg, 2016, 34: 6- 9.
[13] 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.
[14] Wu Q, Liu Z, Zhao X, et al. Outcome of pregnancies after balloon occlusion of the infrarenal abdominal aorta during caesarean in 230 patients with placenta praevia accreta[J]. Cardiovasc Intervent Radiol, 2016, 39: 1573- 1579.
[15] 阳 笑, 陈 政, 游一平. 腹主动脉球囊预置术与髂内动脉球囊预置术在植入型凶险性前置胎盘治疗中的比较研究[J]. 实用妇产科杂志, 2016, 32: 684- 688.
[16] 崔世红, 职云晓, 张 凯, 等. 腹主动脉球囊阻断术在中央型前置胎盘伴胎盘植入孕妇剖宫产术中的应用[J]. 中华妇产科杂志, 2016, 51: 672- 677.
[17] 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.
[18] 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.
[19] No authors listed. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103[J]. Ann ICRP, 2007, 37: 1- 332.
[20] Patel SJ, Reede DL, Katz DS, et al. Imaging the pregnant patient for nonobstetric conditions: algorithms and radiation dose considerations[J]. Radiographics, 2007, 27: 1705- 1722.
[21] Doumouchtsis SK, Arulkumaran S. The morbidly adherent placenta: an overview of management options[J]. Acta Obstet Gynecol Scand, 2010, 89: 1126- 1133.

相似文献/References:

[1]唐军,明德国,刘作勤,等.脑动静脉畸形的血管内栓塞治疗[J].介入放射学杂志,2000,(03):144.
[2]王兴华,朱汉洲,李立.腹部手术后消化道出血的介入诊断与治疗[J].介入放射学杂志,2000,(04):240.
[3]王仲朴,王茂强,吴朝阳.经导管子宫动脉栓塞治疗症状性子宫平滑肌瘤的初步经验[J].介入放射学杂志,2000,(04):210.
[4]陈年根,程国勤,周士福,等.肾血管平滑肌脂肪瘤的血管造影表现及栓塞治疗[J].介入放射学杂志,1997,(01):30.
[5]刘福全,梁君,周经志,等.肝、脾及咽部血管瘤的介入治疗[J].介入放射学杂志,1997,(03):142.
[6]高中度,茅爱武,邵维城,等.动脉灌注化疗并栓塞治疗中晚期恶性肿瘤935例临床疗效及并发症分析[J].介入放射学杂志,1998,(03):151.
[7]李明华,陈君彦,顾斌贤,等.颅内动脉瘤可解脱弹簧栓塞治疗——附28例分析[J].介入放射学杂志,1998,(04):194.
[8]陈君彦,方淳,李明华.肢体深静脉血栓形成215例分析[J].介入放射学杂志,1999,(01):12.
[9]朱景伟,刘卫东,范一木,等.经眼上静脉途径栓塞治疗自发性海绵窦硬膜动静脉瘘[J].介入放射学杂志,1999,(02):0.
[10]许奕,刘建民,周晓平,等.电解可脱卸弹簧圈栓塞颅内动脉瘤[J].介入放射学杂志,1999,(02):5.
[11]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,(12):1036.
 YANG Hou? lin,TANG Yi,FANG Zhu? ting,et al. The clinical application of occlusion of the lower abdominal aorta combined with uterine artery embolization in treating placenta previa associated with placenta accreta: initial experience in 9 cases[J].journal interventional radiology,2013,(04):1036.

备注/Memo

备注/Memo:
(收稿日期:2017-09-20)
(本文编辑:边 佶)
更新日期/Last Update: 2018-04-16