腹主动脉球囊阻断术对凶险性前置胎盘剖宫产患者肾功能、止血效果及妊娠结局的影响

摘要
图/表
参考文献(23)
相关文章 (15)

全文: PDF (571 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨腹主动脉球囊阻断术对凶险性前置胎盘剖宫产患者肾功能、止血效果及妊娠结局的影响。方法回顾性分析2016年1月~2019年1月广西壮族自治区百色市人民医院收治的80例凶险性前置胎盘剖宫产患者的临床资料。根据剖宫术前有无行腹主动脉球囊阻断术将纳入患者分为对照组（42例，行剖宫产术）和观察组（38例，行腹主动脉球囊阻断术后宫产术）。比较两组患者术中临床指标情况、妊娠结局及术后并发症发生情况；比较两组术前，术后24、48、72 h的肾功能指标。结果观察组术中出血量、术中输血量均少于对照组（P < 0.01），手术时间、住院时间短于对照组（P < 0.01）。对照组术后48 h，观察组术后24、48 h肌酐均较术前升高（P < 0.05）；观察组术后48 h尿酸低于对照组（P < 0.05）。观察组产后出血率、术后感染率均低于对照组，而新生儿Apgar评分高于对照组（P < 0.05），两组子宫切除率、新生儿畸形率、术后并发症发生率比较差异无统计学意义（P > 0.05）。结论凶险性前置胎盘剖宫产患者行腹主动脉球囊阻断术，可有效改善围术期指标，改善妊娠结局，且不会对患者肾功能造成很大影响，临床应用价值较高。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	岑炳奎1 王儒发1 李妹燕2 余雷3 潘春红4

关键词 ：腹主动脉球囊阻断术, 凶险性前置胎盘, 剖宫产, 肾功能, 止血效果, 妊娠结局

Abstract：Objective To investigate the effect of abdominal aorta balloon block technique on renal function, hemostasis and pregnancy outcome in patients with dangerous placenta previa undergoing cesarean section. Methods Clinical data of 80 patients with dangerous placenta previa underwent cesarean section from January 2016 to January 2019 in Baise People′s Hospital of Guangxi Zhuang Autonomous Region were analyzed retrospectively. According to whether or not performed abdominal aorta balloon block technique before caesarean section, the patients were divided into control group (42 cases, underwent caesarean section) and observation group (38 cases, underwent caesarean section after abdominal aorta balloon block technique). The clinical index, pregnant outcome and postoperative complications of the two groups were compared. The renal function indexes before operation, 24, 48 and 72 h after operation were compared between the two groups. Results The amount of bleeding and blood transfusion during operation in the observation group were less than those in the control group (P < 0.01), and the operation time and hospitalization time were shorter than those in the control group (P < 0.01). The creatinine level in the control group 48 h after operation and in the observation group 24 h and 48 h after operation were higher than those before treatment (P < 0.05), while the uric acid in the observation group was lower than that in the control group 48 h after operation (P < 0.05). The postpartum hemorrhage rate and infection rate in the observation group were lower than those in the control group, but the Apgar score of newborn was higher than that in the control group (P < 0.05). There were no significant differences in the rate of hysterectomy, neonatal malformation and postoperative complications between the two groups (P > 0.05). Conclusion Abdominal aorta balloon block technique in caesarean section patients with dangerous placenta previa can effectively improve perioperative indicators and pregnancy outcomes, and will not have any great impact on renal function of patients. It has a high clinical value.

Key words： Abdominal aorta balloon block technique Dangerous placenta previa Cesarean section Renal function Hemostatic effect Pregnancy outcome

基金资助:广西医疗卫生科研课题（2016040）；
广西壮族自治区百色市科研与技术开发项目（百科计20170812）。

通讯作者: 潘春红（1973.8-），女，主任医师；研究方向：产科急危重症救治。

作者简介: 岑炳奎（1972.12-），男，副主任医师；研究方向：综合介入诊疗及外周血管介入诊疗技术。

引用本文:

岑炳奎1 王儒发1 李妹燕2 余雷3 潘春红4. 腹主动脉球囊阻断术对凶险性前置胎盘剖宫产患者肾功能、止血效果及妊娠结局的影响[J]. 中国医药导报, 2019, 16(32): 83-86.
CEN Bingkui1 WANG Rufa1 LI Meiyan2 YU Lei3 PAN Chunhong4. Effect of abdominal aorta balloon block technique on renal function, hemostasis and pregnancy outcome in patients with dangerous placenta previa undergoing cesarean section. 中国医药导报, 2019, 16(32): 83-86.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2019/V16/I32/83

[1] Camuzcuoglu A，Vural M，Hilali NG，et al. Surgical management of 58 patients with placenta praevia percreta [J]. Wien Klin Wochenschr，2016，128（9-10）：360-366.
[2] Rowe T. Placenta previa [J]. J Obstet Gynaecol Can，2014， 36（8）：667-668.
[3] 徐亚楠，肖世金，刘伟.80例凶险性前置胎盘伴胎盘植入的流行病学调查研究[J].中国妇幼保健，2018，33（24）：5932-5935.
[4] 余琳，胡可佳，杨慧霞.2008-2014年凶险性前置胎盘的回顾性临床研究[J].中华妇产科杂志，2016，51（3）：169-173.
[5] 周学梅，杨鹏鸣.腹主动脉球囊阻断术在凶险型前置胎盘大出血中的应用（附2例报告）[J].湖北科技学院学报：医学版，2016，30（5）：443.
[6] Peng ZH，Xiong Z，Zhao BS，et al. Prophylactic abdominal aortic balloon occlusion： An effective method of controlling hemorrhage in patients with placenta previa or accrete [J]. Exp Ther Med，2019，17（2）：1492-1496.
[7] 李青春，张建平，胡睿，等.低位腹主动脉球囊阻断术在凶险型前置胎盘剖宫产术中的应用[J].实用放射学杂志，2016，32（6）：938-941.
[8] Killion MM. Correct Use of the Apgar Score [J]. MCN Am J Matern Child Nurs，2016，41（2）：123.
[9] 李洪玲，李明群，朱剑峰.大量输血方案在抢救凶险性前置胎盘产后大出血中的应用效果[J].中国妇幼保健，2018，33（13）：2970-2972.
[10] 汪佳慧.凶险性前置胎盘诊断及治疗进展[J].现代妇产科进展，2019，28（1）：71-73.
[11] Chen M，Lv B，He G，et al. Internal iliac artery balloon occlusion during cesarean hysterectomy in women with placenta previa accrete [J]. Int J Gynaecol Obstet，2019， 145（1）：110-115.
[12] Chen L，Wang X，Wang H，et al. Clinical evaluation of prophylactic abdominal aortic balloon occlusion in patients with placenta accreta：a systematic review and meta-analysis [J]. BMC Pregnancy Childbirth，2019，19（1）：30.
[13] 卢炜，向阳，庄景义，等.腹主动脉内球囊阻断在骨盆及骶骨肿瘤切除重建术中的应用[J].中华骨与关节外科杂志，2018，11（8）：614-616，621.
[14] 胡盈，张雅，袁峰，等.腹主动脉球囊预置术治疗凶险型前置胎盘疗效评价[J].现代生物医学进展，2016，16（28）：5505-5507，5522.
[15] Duan X，Chen P，Han X，et al. Intermittent aortic balloon occlusion combined with cesarean section for the treatment of patients with placenta previa complicated by placenta accreta：A retrospective study [J]. J Obstet Gynaecol Res，2018，44（9）：1752-1760.
[16] Yang Y，Zhao X，Tang X，et al. Comparison of Serum Cystatin C and Creatinine Level Changes for Prognosis of Patients After Peripheral Arterial Angiography [J]. Angiology，2015，66（8）：766-773.
[17] Umazume T，Hayasaka S，Kato F，et al. Sudden maternal hypoxemia during elective cesarean section in a woman with placenta previa [J]. Clin Case Rep，2017，5（10）：1668-1671.
[18] Soyama H，Miyamoto M，Sasa H，et al. Effect of routine rapid insertion of Bakri balloon tamponade on reducing hemorrhage from placenta previa during and after cesarean section [J]. Arch Gynecol Obstet，2017，296（3）：469-474.
[19] 李继军，左常婷，王谢桐，等.腹主动脉球囊阻断术在凶险性前置胎盘并胎盘植入剖宫产术中的应用[J].山东大学学报：医学版，2016，54（9）：22-25.
[20] Cui S，Zhi Y，Cheng G，et al. Retrospective analysis of placenta previa with abnormal placentation with and without prophylactic use of abdominal aorta balloon occlusion [J]. Int J Gynaecol Obstet，2017，137（3）：265-270.
[21] 宫玉凤，朴桂顺，冯淑香，等.间歇性腹主动脉阻断在凶险性前置胎盘剖宫产中应用价值[J].中国现代医生，2019，57（5）：58-60，63.
[22] 李荣，卢余莉.凶险性前置胎盘伴胎盘植入术中、术后不同止血方式比较[J].成都医学院学报，2018，13（4）：456-459，466.
[23] 徐亚辉，刘侃，闫君，等.凶险型前置胎盘合并胎盘植入行腹主动脉与双侧髂内动脉球囊阻断术的效果及妊娠结局分析[J].中国计划生育学杂志，2018，26（5）：393-396.