国际妇产科学杂志 ›› 2018, Vol. 45 ›› Issue (5): 549-552.

• 综述 • 上一篇    下一篇

腹主动脉球囊阻断在凶险性前置胎盘患者剖宫产术中的应用

丁楠,武海英   

  1. 450003  郑州,河南省人民医院产科
  • 收稿日期:2018-06-22 修回日期:2018-08-06 出版日期:2018-10-15 发布日期:2018-10-18
  • 通讯作者: 武海英,E-mail:whysunnyzg@163.com E-mail:whysunnyzg@163.com
  • 基金资助:
    河南省医学科技攻关计划项目(201602207)

Application of Abdominal Aortic Balloon Occlusion in the Cesarean Section for Patients with Pernicious Placenta Previa

DING Nan,WU Hai-ying   

  1. Department of Obstetrics,Henan Provincial People′s Hospital,Zhengzhou 450003,China
  • Received:2018-06-22 Revised:2018-08-06 Published:2018-10-15 Online:2018-10-18
  • Contact: WU Hai-ying,E-mail:whysunnyzg@163.com E-mail:whysunnyzg@163.com

摘要:  随着剖宫产率的升高,凶险性前置胎盘的发生率也逐年升高,分娩时可发生难以控制的大出血,且子宫切除率高,临床处理困难,严重威胁孕产妇的生命。其发病原因主要与剖宫产术后瘢痕形成过程中子宫蜕膜发育与滋养细胞侵袭之间的失调有关。如何有效地控制产时产后出血、保留患者的子宫是抢救凶险性前置胎盘成功的关键。近年来国内外医师探索在剖宫产过程中联合腹主动脉球囊阻断技术来控制术中出血风险,降低子宫切除率。虽然腹主动脉球囊阻断技术操作简单易行,止血效果明显,可使手术视野清晰,但是其同时也存在多种影响因素和手术相关并发症,其价值及风险仍在逐步认识阶段。现就腹主动脉球囊阻断技术的发展过程、其应用于凶险性前置胎盘的优势及弊端进行综述。

关键词: 前置胎盘, 主动脉, 腹, 剖宫产术, 产后出血

Abstract: With the increase of cesarean section rate, the incidence of pernicious placenta previa is also increasing year by year, which leads to an uncontrolled bleeding during the childbirth, a high rate of uterus resection, and a difficulty in clinical treatment, thereby severely threatening the life of the pregnant woman. The cause of the pernicious placenta previa mainly involves with the imbalance between the uterine decidual development and the trophoblast invasion during scar formation after cesarean section. Accordingly, the ways of an effective control on the intro-partum and postpartum hemorrhage as well as of retaining the uterus of the patient is credited as the key to the success of the rescue for the pernicious placenta previa. Recent domestic and foreign physicians have explored the application of coupling the technique of abdominal aortic balloon occlusion in the cesarean section to control the risk of intraoperative bleeding and reduce the rate of hysterectomy. Although the technique of the abdominal aortic balloon occlusion is simple and easy to operate, with obvious hemostatic effect and clear surgical field, it also has many influencing factors and surgical complications. The knowledge to its value and risk is still in the stage of gradual understanding. For this end, the development process, advantages and limitations of the abdominal aortic balloon occlusion will be reviewed overall in this paper.

Key words: Placenta previa, Aorta, abdominal, Cesarean section, Postpartum hemorrhage