[1]张建好,韩新巍,赵先兰,等.腹主动脉球囊阻断在剖宫产术中应用及相关问题探讨[J].介入放射学杂志,2018,27(08):725-729.
 ZHANG Jianhao,HAN Xinwei,ZHAO Xianlan,et al.The application of balloon occlusion of abdominal aorta in cesarean section and the discussion of its related issues[J].journal interventional radiology,2018,27(08):725-729.
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腹主动脉球囊阻断在剖宫产术中应用及相关问题探讨()

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

卷:
27
期数:
2018年08期
页码:
725-729
栏目:
血管介入
出版日期:
2018-08-25

文章信息/Info

Title:
The application of balloon occlusion of abdominal aorta in cesarean section and the discussion of its related issues
作者:
张建好 韩新巍 赵先兰 王晓娟 周 艳 李秀芳 刘慧娜 张 梅
Author(s):
ZHANG Jianhao HAN Xinwei ZHAO Xianlan WANG Xiaojuan ZHOU Yan LI Xiufang LIU Huina ZHANG Mei FENG Zhipeng LI Zongming.
Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province 450052, China
关键词:
【关键词】 球囊阻断腹主动脉 前置胎盘 胎盘植入 出血量 手术时间 胎儿辐射 动脉血栓形成
文献标志码:
A
摘要:
【摘要】 目的 探讨腹主动脉球囊阻断在凶险型前置胎盘(PPP)伴胎盘植入剖宫产术中的应用价值,分析技术重点及相关问题处理。方法 对97例PPP伴胎盘植入产妇行球囊阻断腹主动脉辅助下剖宫产(观察组),同时对97例PPP伴胎盘植入产妇直接行剖宫产(对照组)。观察组剖宫产术前预置球囊导管于髂动脉分叉上方腹主动脉,胎儿头娩出后充盈球囊阻断腹主动脉,剥离胎盘并缝合剥离面止血,创面充分缝合仍出血行子宫动脉栓塞,栓塞后再出血则行子宫次全切除。记录观察组术中出血量、手术时间、子宫保留与否、胎儿X线辐射剂量、术后并发症等情况。结果 观察组97例均成功预置腹主动脉球囊,辅助剖宫产完成分娩,保留子宫96例,次全切除1例;对照组97例中11例切除子宫。观察组、对照组平均出血量分别为(1 238.0±139.2) mL、(3 373.0±196.3) mL(P<0.001),手术时间分别为(70.6±3.6) min、(128.6±6.2) min(P<0.000 1)。观察组胎儿辐射剂量为(6.1±1.4) mGy;术后5例产妇发生髂股动脉血栓形成,溶栓后血栓消失,未出现肾功能损伤、血管破裂、下肢缺血等严重并发症。结论 球囊阻断腹主动脉辅助PPP伴胎盘植入产妇剖宫产手术,可明显减少术中出血量,缩短手术时间,显著降低子宫切除风险。对术中胎儿辐射、球囊置放、动脉血栓等问题应有充分认识,严格控制适应证,尽量避免并发症发生并及时处理。

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备注/Memo

备注/Memo:
(收稿日期:2017-11-07)
(本文编辑:边 佶) 冯志鹏, 李宗明
更新日期/Last Update: 2018-08-17