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目的:评价“一站式杂交技术”在凶险型前置胎盘患者治疗中的应用价值。方法:12例凶险型前置胎盘患者在杂交手术室同期行剖宫产和腹主动脉或髂内动脉球囊导管阻断(即杂交技术)。另外选择先在介入室预置髂内动脉球囊随后转手术室行剖宫产,术中充盈球囊阻断髂内动脉的12例凶险型前置胎盘病例作为对照组。术中严密观察血压、心率等血流动力学指标,比较两组手术时间、术中出血量、输血量、输液量、尿量、术后24 h内出血量、子宫切除率及新生儿情况等。结果:杂交手术组术中血压、心率等指标较对照组稳定,手术时间(72±8)min,术中出血量(620±95)mL、输血量(550±40)mL、输液量(1 850±160)mL、术后24 h内出血量(75±9)mL,均显著低于对照组(均P<0.05);两组术后均无严重并发症,新生儿出生时Apgar评分、体质量等指标比较差异无显著性(均P<0.05)。结论:“一站式杂交技术”对控制凶险型前置胎盘患者术中出血的作用明显,值得在有条件的医院推广。
Objective: To evaluate the value of “one-stop hybridization technique” in the treatment of patients with aggressive placenta previa. METHODS: Twelve patients with aggressive placenta previa were involved in cesarean section and abdominal or internal iliac artery balloon catheter occlusion (ie, hybridization technique) in the hybrid operating room. In addition, the first choice in the interventional chamber preset internal iliac artery balloon surgery room after cesarean section, intraoperative filling of the balloon iliac artery blocking the 12 cases of placenta previa placenta as a control group. Intraoperative blood pressure, heart rate and other hemodynamic indicators, the two groups were compared operation time, intraoperative blood loss, blood transfusion, infusion volume, urine output, intraoperative bleeding within 24 h, hysterectomy and neonatal conditions. Results: The intraoperative blood pressure and heart rate in the hybrid surgery group were significantly lower than those in the control group. The operative time (72 ± 8) min, blood loss (620 ± 95) mL, blood transfusion (550 ± 40) mL, 850 ± 160) mL and blood loss within 24 h after operation (75 ± 9) mL, all of which were significantly lower than those of the control group (all P <0.05). There was no serious complication after operation in both groups. Apgar score, Quality and other indicators no significant difference (all P <0.05). Conclusion: The one-stop hybridization technique has obvious effect on the control of intraoperative bleeding in patients with dangerous placenta previa. It is worth to be promoted in qualified hospitals.