ABSTRACT
Objective To compare the clinical efficacy of extra vascular occlusion of low abdominal aorta and low abdominal aorta balloon occlusion in the treatment of placenta previa with placenta previa.Methods From January 2014 to July 2017,68 implantable placenta previa patients were divided into two groups,elective cesarean section of extra vascular occlusion of low abdominal aorta in 34 cases(group A)and cesarean section on the lower abdominal aorta balloon occlusion in 34 cases(group B),and observation of pregnant women was compared between surgery of two groups. Results Operation time,complications of vascular injury and thrombosis,fetal radiation exposure in group A were significantly lower than that of group B(P<0.05);two groups of patients with sensory dysfunction incidence,cesarean operation time,intraoperative blood loss,blood transfusion rate,the uterus resection rate,hospitalization time had no statistically significant difference postoperatively(P > 0.05). Conclusion Two kinds of operation can safely and effectively reduce the bleeding during the treatment of placenta previa. While group A surgery operation time is short,without intraoperative and postoperative bleeding of the puncture site,without pelvic and lower extremity arterial thrombosis,without X-ray exposure,more safety of the womb and can be popularized in clinic.
ABSTRACT
Objective To discuss the clinical effect of prophylactic abdominal aorta balloon occlusion with Fogarty catheter before cesarean section in treating delivery woman with pernicious placenta previa.Methods The clinical data of 12 delivery women with pernicious placenta previa,who received prophylactic abdominal aorta balloon occlusion with Fogarty catheter before cesarean section,were retrospectively analyzed.The curative effect was evaluated.Results The average intraoperative blood loss in the 12 patients was (1256±318) ml.The uterus was successfully retained in 9 patients.Hysterectomy had to be carried out in 3 patients because of refractory hemorrhage;one of them had to receive total hysterectomy together with bladder repair as the placenta had penetrated into the bladder wall.After delivery no complications,such as infection,delayed hemorrhage,lower limb thrombosis,etc.,occurred.All 12 neonates were born smoothly.Conclusion Prophylactic abdominal aorta balloon occlusion with Fogarty catheter before cesarean section can effectively reduce intraoperative blood loss and help save the uterus.Therefore,it is a safe and effective therapeutic means for delivery woman with pernicious placenta previa before the performance of cesarean section.
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Objective To investigate the risk factors of wound complications following the abdominal aorta balloon occlusion in order to provide the basis for the preoperative management and reduce postoperative complications.Methods Two hundred and sixty-one patients with the sacral tumor aged over 18 were selected as subjects who hospitalized at Peking University People's Hospital from January 2006 to December 2012.All subjects were underwent sacral tumor posterior resection operation after occlusion of the distal abdominal aorta.Patients were divided into two groups according to the existence of postoperative wound disorder.The general information of the patients was collected including intra-operative data and post-operative data.SPSS19.0 software was applied for statistic analysis Results Among 261 cases,89 cases were with incision complications,and the incidence of complications was 34.1％ (89/261).There was no significant difference regarding of age,weight,preoperative complications (P ＜ 0.05).Compared with that of no complications group,operation time of wound complications group was longer ((218.27 ± 72.08) min vs.(197.40 ± 53.92) min,P =0.046),and intra-operative bleeding was more ((2368.0 ± 1984.7) ml vs.(1701.6 ±958.8) ml,P =0.000),as well as a longer balloon occlusion time ((78.0 ± 23.8) rain vs.(65.2 ± 17.8) min,P =0.005).Moreover long hospitalized periods was in wound complications group ((47.6 ± 26.3) d,vs.(26.7 ± 9.0) d,P ＜ 0.05).Single factor analysis showed that the factors including operation time,intra-operative bleeding volume,time and times of balloon occlusion balloon occlusion were related to postoperative wound complications.Non conditional logistic regression analysis shows that factors of the balloon occlusion time(OR 1.028,95％ CI 1.012-1.045,P =0.001) and block number(OR 6.266,95％ CI 1.186-33.119,P =0.031) were related to the wound healing following balloon occlusion the abdominal aorta.Conclusion The risk factors of wound complications following the abdominal aorta balloon occlusion included occurrence balloon occlusion time and blocking times.That single balloon occlusion with 60 min reduced wound complication rate.