学术论文

      104例凶险型前置胎盘患者行腹主动脉球囊阻断术对妊娠结局和生育功能的影响

      Effects of abdominal aortic balloon blockage on the pregnancy outcome and reproductive functions of 104 patients with pernicious placenta previa

      摘要:
      目的:探究腹主动脉球囊阻断术对凶险型前置胎盘患者的妊娠结局和生育功能的影响.方法:选取2014年1月至2016年7月在我院行腹主动脉球囊阻断术的凶险型前置胎盘患者104例作为观察组,并且同时选取同期未行腹主动脉球囊阻断术的87例凶险型前置胎盘患者作为对照组,记录和比较两组患者的手术出血量、输血量、手术时间、胎盘植入类型、切除子宫情况、新生儿体重、新生儿Apgar评分、新生儿、术后感染情况.结果:观察组的年龄、孕周、孕次、产次、既往剖宫产、新生儿体重、胎盘植入类型与对照组的差异无统计学意义(P>0.05).而观察组的手术出血量为(1283.5±235.4) mL,少于对照组的(2883.9±441.4)mL,差异有统计学意义(P<0.05);观察组的输血量(832.4±184.0)mL也少于对照组的(1548.3±204.8)mL,差异有统计学意义(P<0.05).两者的子宫切除率比较显示,观察组的患者的子宫切除率为20.2%低于对照组的32.2% (P <0.05).观察组手术的感染率为16.4%低于对照组的32.2%(P<0.05).出生结局比较显示,观察组的新生儿的Apgar评分(7.8±1.1)分高于对照组的(7.0±0.9)分(P<0.05);而观察组新生儿的畸形率7.7%与对照组的6.9%的差异无统计学意义(P>0.05).结论:腹主动脉球囊阻断术能有效的减少凶险型前置胎盘患者的手术出血量以及输血量,减少子宫切除情况的发生,对胎儿辐射属安全范围.
      Abstract:
      Objectives:To explore the effects of abdominal aortic balloon blockage on the pregnancy outcome and reproductive functions of 104 patients with pernicious placenta previa.Methods:104 patients with pernicious placenta previa receiving abdominal aortic balloon blockage in our hospital from January 2014 to July 2016 were selected as observation group.87 patients with pernicious placenta previa who did not receive abdominal aortic balloon blockage were selected as control group.The surgical blood loss,blood transfusion amount,operation time,the types of placenta implantation,hysterectomy,neonatal Apgar score,neonatal birth weight and postoperative infection of two groups were compared.Results:The age,gestational age,pregnant times,productive times,previous cesarean delivery,birth weight and the types of placenta implantation of observation group had no statistically significant difference with control group (P >0.05).The surgical blood loss of observation group was 1283.5 ± 235.4 ml,which was less than that of control group (2883.9-± 441.4 ml),and the difference was statistically significant (P <0.05);Amount of blood transfusion of observation group was 832.4 ± 184.0 ml,which was less than that of control group(1548.3 ± 204.8 ml),and the difference was statistically significant (P < 0.05).Uterus resection rate of observation group was 20.2%,which was less than that of control group(32.2%,P < 0.05).The surgical infection rate of observation group was 16.4%,which was less than that of control group (32.2%,P < 0.05).Neonatal Apgar scoreofobservation group was 7.8 ± 1.1 points,which was higher than that of control group (7.0 ± 0.9,P < 0.05);the malformation rate of two groups had no significant difference (P > 0.05).Conclusion:Abdominal aortic balloon blockage can effectively reduce the surgery blood loss and transfusion volume and reduce the occurrence of hysterectomy.
      作者: 陈姣 [1] 熊浩然 [2] 吴晓兰 [1]
      Author: CHEN Jiao [1] XIONG Haoran [2] WU Xiaolan [1]
      作者单位: 成都市第五人民医院妇产科,成都,611130 成都市第五人民医院检验科,成都,611130
      刊 名: 中国性科学 ISTIC
      年,卷(期): 2017, 26(11)
      分类号: R714.56
      在线出版日期: 2017年12月22日
      基金项目: 四川省成都市卫生和计划生育委员会科研项目