比较髂内动脉临时阻断和腹主动脉临时阻断在凶险性前置胎盘剖宫产中的应用价值。

2015年10月—2016年8月我院收治的24例凶险性前置胎盘患者，在剖宫产术中待胎头娩出后，12例行髂内动脉球囊临时阻断（髂内动脉临时阻断组）、12例行腹主动脉球囊临时阻断（腹主动脉临时阻断组），然后再行胎盘剥离和出血点的缝合，比较2组的临床效果及并发症发生情况。

髂内动脉临时阻断组的球囊置入时间[21（2.5，30.2）min]和射线量[23.85（19.95, 25.45）mGy]均高于腹主动脉临时阻断组的[4（3.0,9.5）min]和[1.21（0.90,2.51）mGy]，差异有统计学意义（Z值分别为4.18、4.16，P值均<0.01），而两种方法的出血量差异无统计学意义[800（700,1500）ml vs.750（550,1000）ml，Z=0.91, P=1.00]。

两种球囊临时阻断方法都能明显的降低剖宫产术中出血量、降低子宫切除率。腹主动脉临时阻断较髂内动脉临时阻断具有球囊置入时间短、辐射量低、出血量少的优点。

To compare the application value of temporary internal iliac artery occlusion and temporary abdominal aorta occlusion in caesarean delivery for patients with pernicious placenta previa.

A total of 24 patients with pernicious placenta previa admitted to and treated at our hospital (2015.10—2016.8) were recruited in this study. After fetal head delivered, temporary internal iliac artery balloon occlusion was placed in 12 patients (TIIABO group), and temporary abdominal aorta balloon occlusion was placed in another 12 patients (TAABBO group). Following that, the placental separation and suture at bleeding site were performed. Clinical efficacy and complication occurrence between two groups were compared.

Balloon placement time [21 (2.5, 30.2) min] and radiation amount [23.85 (19.95, 25.45) mGy] in TIIABO group were all higher than those in TAABBO group [4 (3.0, 9.5) min; 1.21 (0.90, 2.51) mGy], and the difference was statistically significant (Z:4.18, 4.16, P <0.01). No statistical significance was observed in bleeding amount between two groups [800 (700, 1500) ml vs. 750 (550,1000) ml, Z=0.91, P=1.00].

Both of the two temporary balloon occlusion methods significantly reduce the bleeding amount during caesarean delivery and as well as the uterectomy rate. Temporary abdominal aorta occlusion is superior to temporary internal iliac artery occlusion in terms of balloon placement time, which is shorter, low radiation and less bleeding amount.