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目的探讨腹主动脉球囊阻断术在凶险性前置胎盘并胎盘植入患者剖宫产术中的临床应用。方法回顾分析65例凶险性前置胎盘并胎盘植入患者的临床资料。全部患者均于剖宫产术前在介入室行股动脉插管并送入球囊导管,球囊放置于腹主动脉下段,手术中充盈球囊临时阻断主动脉血流。记录剖宫产术中出血量、子宫切除例数、孕妇接受射线剂量。结果手术中出血量200~4 500 m L,平均1 520 m L;术中、术后输红细胞0~3 600 m L,平均1 040 m L;无产妇及胎儿死亡及严重并发症。7例行子宫切除术(10.8%)。结论腹主动脉球囊阻断术可有效控制凶险性前置胎盘剖宫产术中出血、减少子宫切除率,辐射剂量对胎儿安全。但风险不可忽视,应严格掌握适应证。
Objective To investigate the clinical application of abdominal aorta balloon occlusion in caesarean section of dangerous placenta previa and placenta accreta. Methods A retrospective analysis of 65 cases of placenta previa placenta accreta implanted in patients with clinical data. All patients were intubated before the cesarean section in the interventional ventricle femoral artery and into the balloon catheter, the balloon placed in the lower abdominal aorta, filling the balloon during surgery to temporarily block the aortic blood flow. Record cesarean section bleeding, hysterectomy cases, pregnant women accept radiation dose. Results The amount of bleeding during operation was 200-4 500 m L, with an average of 1 520 m L. Intraoperative and postoperative transfusion of red blood cells was 0-3 600 m L (average 1040 m L). There were no maternal and fetal deaths and serious complications. Seven routine hysterectomy (10.8%). Conclusion Abdominal aortic balloon occlusion can effectively control the risk of placenta previa bleeding, reduce the rate of hysterectomy, radiation dose on the fetus. But the risk can not be ignored, should be strictly controlled.