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          |本期目錄/Table of Contents|

          [1]田 瓊,楊 梅.髂總動脈對比髂內動脈球囊阻斷術在胎盤植入的剖宮產術中的比較[J].福建醫科大學學報,2020,54(02):121-126.
           TIAN Qiong,YANG Mei.Compare Clinical Outcomes of Prophylactic Balloon Occlusion of InternalIliac Arteries and Common Iliac Arteries in Patients with Placenta Accrete[J].Journal of Fujian Medical University,2020,54(02):121-126.





          Compare Clinical Outcomes of Prophylactic Balloon Occlusion of InternalIliac Arteries and Common Iliac Arteries in Patients with Placenta Accrete
          田 瓊1 楊 梅2
          武漢市第四醫院,華中科技大學 同濟醫學院附屬普愛醫院,武漢 430000 1. 產科; 2. 婦科
          TIAN Qiong1 YANG Mei2
          1.Department of Obstetrics, The Fourth Hospital of Wuhan, Wuhan Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China; 2.Department of Gynecology, The Fourth Hospital of Wuhan, Wuhan Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
          髂動脈 胎盤侵入性 失血 手術 隊列效應
          iliac artery placenta accreta blood loss surgical cohort effect
          R322.121; R714.462; R714.56
          目的 對比髂總動脈(CIA)和髂內動脈(IIA)預防性球囊阻斷術對于胎盤植入患者剖宮產術中、術后出血以及圍手術期相關指標的影響。 方法 回顧性分析95例行預防性球囊阻斷術的胎盤植入患者的臨床資料。CIA組55例,接受CIA預防性球囊阻斷術; IIA組40例,接受IIA預防性球囊阻斷術。分析比較兩組患者的術中估算的失血量(EBL)、24 h EBL、輸血量以及圍手術期其他相關指標的差異。 結果 CIA組的EBL和24 h EBL均低于IIA組(P<0.001),而兩組的輸血量差別無統計學意義(P=0.306)。CIA組的住院時間較IIA組短(P=0.034),1分鐘阿氏評分較IIA組高(P=0.048),而兩組的手術時間(P=0.218)、輻射劑量(P=0.733)、球囊擴張時間(P=0.600)、子宮切除率(P=0.967)、ICU住院率(P=0.173)以及新生兒體質量(P=0.265)差別均無統計學意義。此外,進一步多元線性分析發現,CIA預防性球囊阻斷術相較于IIA預防性球囊阻斷術可獨立預測更低的術中EBL(P=0.027)。 結論 相較于IIA預防性球囊阻斷術,CIA預防性球囊阻斷術對于降低胎盤植入患者的術中EBL、24 h EBL、住院時間和提高新生兒阿氏評分效果更好。
          Objective To compare the haemostatic effects and clinical perioperative outcomes of prophylactic balloon occlusion(PB)of internal iliac arteries(IIA)and common iliac arteries(CIA)in patients with placenta accrete. Methods 95 patients with placenta accrete were retrospectively reviewed. Among them, 55 who underwent PB of CIA were allocated into CIA group, and 40 who underwent PB of IIA were classified into IIA group. We compared the estimated blood loss(EBL), 24 h EBL, blood transfusion volume(BTV), and other related perioperative outcomes between two groups. Results CIA group had less EBL(P<0.001)and 24 h EBL(P <0.001)compared to IIA group, while BTV between two groups were similar(P=0.306). CIA group had decreased length of postoperative hospital stay(P=0.034), and higher apgar score(P=0.048)compared with IIA group, but two groups had similar operation duration(P=0.218), radiation dose(P=0.733), balloon dilatation duration(P =0.600), hysterectomy rate(P=0.967), need for ICU admission(P=0.173), and weight of newborn(P=0.265). Further multivariate linear regression analysis revealed CIA(vs IIA)could independently predict less EBL(P=0.027). Conclusion PB of CIA is more effective in decreasing EBL, 24 h EBL and length of postoperative hospital stay, and improving apgar score compared with IIA in patients with placenta accrete.


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          [1]甘 玲,李海英,劉新秀,等.產后胎盤滯留的超聲造影聲像表現及臨床指導意義[J].福建醫科大學學報,2019,53(02):120.
           GAN Ling,LI Haiying,LIU Xinxiu,et al.Contrast-Enhanced Ultrasound Imaging of Postpartum Placenta Retention and its Clinical Guiding Significance[J].Journal of Fujian Medical University,2019,53(02):120.


          收稿日期: 2019-07-12作者簡介: 田 瓊,女,護師通訊作者: 楊 梅. Email: yuanli13753@163.com
          更新日期/Last Update: 2020-04-30