腹主动脉远端预置球囊阻断治疗凶险型前置胎盘的临床分析(2)
笔者所在医院近2年来,产科、血管外科、麻醉科、新生儿科医护人员共同协作,应用腹主动脉远端预置球囊阻断技术行剖腹产术12例,术中充盈球囊阻断腹主动脉后,手术野清晰,宫腔出血量明显减少。我科医生从容快速剥离胎盘,缝扎止血,有效地控制了术中术后出血并保留子宫,减少输血量,临床效果满意,术后并发症少。新生儿Apgar评分均正常。产后42 d随访,12例患者均未发生晚期产后出血,仅1例并发右下肢静脉血栓仍在治疗中,其余均未出现相关并发症。多学科融洽合作、密切配合在整个实施过程中尤为重要。
综上所述,腹主动脉球远端预置球囊阻断技术在凶险性前置胎盘剖宫产中,能减少产后出血及输血量,缩短剖宫产时间,减少子宫切除风险,并发症少,实为一安全有效的治疗手段,值得推广应用。
参考文献
[1]谢幸,苟文丽.妇产科学[M].第8版.北京:人民卫生出版社,2013:126-129.
[2] ACOG Committee Opinion.Placenta accreta.American College of Obstetricians and Gynecologists[J].Obstet Gynecol,2012,120(5):207
[3]彭方亮,周晓,毛世华.子宫动脉栓塞术治疗剖宫产后子宫瘢痕部位妊娠40例临床分析[J].重庆医学,2012,41(12):1189-1190.
[4] Garmi G,Salim R.Epidemiology,etiology,diagnosis,and management of placenta accreta[J].Obstet Gynecol Int,2012,15(6):873-929.
[5] Sadashivaiah J,Wilson R,Thein A,et al.Role of prophylactic uterine artery balloon catheters in the management of women with suspected placenta accreta[J].Int J Obstet Anesth,2011,20(8):282-287.
(收稿日期:2014-10-08) (编辑:黄新珍), http://www.100md.com(淦蓓)
综上所述,腹主动脉球远端预置球囊阻断技术在凶险性前置胎盘剖宫产中,能减少产后出血及输血量,缩短剖宫产时间,减少子宫切除风险,并发症少,实为一安全有效的治疗手段,值得推广应用。
参考文献
[1]谢幸,苟文丽.妇产科学[M].第8版.北京:人民卫生出版社,2013:126-129.
[2] ACOG Committee Opinion.Placenta accreta.American College of Obstetricians and Gynecologists[J].Obstet Gynecol,2012,120(5):207
[3]彭方亮,周晓,毛世华.子宫动脉栓塞术治疗剖宫产后子宫瘢痕部位妊娠40例临床分析[J].重庆医学,2012,41(12):1189-1190.
[4] Garmi G,Salim R.Epidemiology,etiology,diagnosis,and management of placenta accreta[J].Obstet Gynecol Int,2012,15(6):873-929.
[5] Sadashivaiah J,Wilson R,Thein A,et al.Role of prophylactic uterine artery balloon catheters in the management of women with suspected placenta accreta[J].Int J Obstet Anesth,2011,20(8):282-287.
(收稿日期:2014-10-08) (编辑:黄新珍), http://www.100md.com(淦蓓)