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目的探讨超声导引球囊阻断术在凶险性前置胎盘产妇行剖宫产手术中的应用价值。方法曲靖市第一人民医院介入科联合超声科,协助产科完成凶险性前置胎盘剖宫产手术共13例,13例产妇均经彩色超声和MRI诊断为中央型前置胎盘。剖宫产术前于双侧髂总动脉或腹主动脉预置封堵球囊,胎儿娩出同时立即充盈球囊对目标血管进行临时封堵,并根据产科医师止血状况,适时撤出球囊。结果 13例中1例为腹主动脉封堵,12例为双侧髂总动脉封堵。13例中12例经超声导引封堵成功,平均阻断时间<15 min,术中出血量800~1 500 ml。结论剖宫产前超声导引球囊阻断术治疗凶险性前置胎盘安全可靠,可明显减少术中出血,无X线辐射,值得临床推广。
Objective To investigate the value of ultrasound-guided balloon occlusion in caesarean section of dangerous placenta previa. Methods The First People ’s Hospital of Qujing interventional ultrasound department, assisted obstetric completion of dangerous placenta previa cesarean section in 13 cases, 13 cases of mothers by color ultrasound and MRI diagnosis of central placenta previa. Preoperative cesarean section in the bilateral common iliac artery or abdominal aorta pre-closure balloon, the fetus was delivered at the same time filling the balloon immediately on the target vessel temporary occlusion, and according to the obstetrician to stop bleeding, timely withdrawal balloon. Results In 13 cases, 1 case had abdominal aorta occlusion and 12 cases had bilateral common iliac artery occlusion. In 13 cases, 12 cases were successfully blocked by ultrasound guidance. The mean interruption time was less than 15 minutes and the intraoperative blood loss was 800-1,500 ml. Conclusion Cesarean section ultrasound guided balloon occlusion for the treatment of dangerous placenta previa is safe and reliable, can significantly reduce intraoperative bleeding, no X-ray radiation, worthy of clinical promotion.