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目的探讨双侧髂内动脉球囊封堵术在凶险性前置胎盘孕妇剖宫产术中的应用效果。方法选取2011年10月-2016年10月杭州市妇产科医院收治的行剖宫产手术的86例凶险性前置胎盘孕妇为研究对象,将术前预防性应用双侧髂内动脉球囊封堵术的46例孕妇作为观察组,行常规剖宫产术的40例孕妇作为对照组。比较两组患者术中宫腔球囊填塞、胎盘植入、子宫切除、术中出血量、产后出血及新生儿窒息情况的差异。结果两组患者术中使用球囊填塞率、胎盘植入率及产后出血率比较,差异均无统计学意义(P>0.05);对照组患者术中平均出血量和子宫切除率均显著高于观察组,差异有统计学意义(P<0.05);对照组新生儿窒息发生率高于观察组,但差异无统计学意义(P>0.05)。结论凶险性前置胎盘孕妇剖宫产术前预防性应用双侧髂内动脉球囊封堵术可以有效降低术中出血量,降低子宫切除率,减少术后并发症。
Objective To investigate the effect of balloon occlusion of bilateral internal iliac arteries in caesarean section of pregnant women with dangerous placenta previa. Methods Totally 86 pregnant women with malignant placenta previa who underwent cesarean section from October 2011 to October 2016 in Hangzhou Obstetrics and Gynecology Hospital were enrolled in this study. Preoperative prophylactic application of bilateral internal iliac artery balloon Forty-six pregnant women who underwent occlusion were selected as the observation group and 40 pregnant women underwent conventional cesarean section as the control group. The differences of intrauterine balloon tamponade, placenta accreta, hysterectomy, intraoperative blood loss, postpartum hemorrhage and neonatal asphyxia were compared between the two groups. Results There was no significant difference in balloon tamponade rate, placenta accreta rate and postpartum hemorrhage between the two groups (P> 0.05). The mean intraoperative blood loss and hysterectomy rate in the control group were significantly higher than those in the control group The difference was statistically significant (P <0.05). The incidence of neonatal asphyxia in the control group was higher than that in the observation group, but the difference was not statistically significant (P> 0.05). Conclusion Preoperative cesarean section in precancerous pre-placenta previa patients with prophylactic use of bilateral internal iliac artery balloon occlusion can effectively reduce intraoperative blood loss, reduce the hysterectomy rate and reduce postoperative complications.