探讨腹主动脉球囊封堵联合剖宫产术治疗凶险性前置胎盘的安全性和有效性，评估其对患者生育功能和新生儿健康状况的影响。

回顾性分析2013年1月至2019年1月我院收治的1 018例凶险性前置胎盘患者的临床资料。所有患者均接受腹主动脉球囊封堵联合剖宫产术治疗。本研究旨在通过分析1 018例患者的手术时间、术中出血量、输血量、术中和术后并发症、术后恢复情况以及胎儿射线暴露时间和剂量、新生儿Apgar评分等评估腹主动脉球囊封堵联合剖宫产术治疗凶险性前置胎盘的安全性和有效性。

所有1 018例患者中，940例仅接受腹主动脉球囊封堵术，78例因术后活动性出血紧急行子宫动脉栓塞术，所有患者均成功保全子宫，除8例发生右侧股动脉血栓、3例发生右下肢肌间静脉血栓外，其余患者术后均未发生下肢动静脉血栓、肾功能不全、晚期产后出血、异位栓塞、脊髓及周围神经损害及盆腔感染等严重并发症。平均手术时间（57.6±17.3）min。平均术中出血量（590±570）mL。126例（12.38%，126/1018）给予输血治疗，平均输血量（630±450）mL。1 018例平均住院天数（6.4±4.2）d，胎儿射线暴露平均时间为（5.1±1.4）s，平均剂量为（4.0±2.6）mGy。新生儿Apgar评分，1 min为（9.2±0.4）分，5 min为（9.6±0.3）分。随访至2019年5月31日，38例失访，137例处于哺乳期，843例月经复潮。除38例失访外，余982名存活新生儿（其中2例双胞胎）出生后42 d门诊随访检查均未见异常。

腹主动脉球囊封堵联合剖宫产术治疗凶险性前置胎盘，能够降低子宫切除风险，减少术中出血量，对孕妇和新生儿无不良影响，是一种安全、有效的治疗方法。

To investigate the safety and efficacy of abdominal aortic balloon occlusion combined with cesarean section in the treatment of pernicious placenta previa, and to evaluate its impact on the reproductive function and neonatal health.

The clinical data of 1 018 patients with pernicious placenta previa admitted to our hospital from January 2013 to January 2019 were retrospectively analyzed. All patients received abdominal aortic balloon occlusion combined with cesarean section. The purpose of this study was to evaluate the safety and efficacy of abdominal aortic balloon occlusion combined with cesarean section in the treatment of dangerous placenta previa by analyzing the operation time, intraoperative blood loss, blood transfusion, intraoperative and postoperative complications, postoperative recovery, fetal radiation exposure time and dose, and neonatal Apgar score in 1 018 cases.

Among all the 1 018 patients, 940 patients received only abdominal aortic balloon occlusion, 78 patients underwent uterine artery embolization due to postoperative bleeding. All patients successfully preserved the uterus. Except for 8 cases of right femoral artery thrombosis and 3 cases of right lower limb intermuscular venous thrombosis, the remaining patients did not have postoperative lower limb arteriovenous thrombosis, renal insufficiency, late postpartum hemorrhage, ectopic embolism, spinal cord or peripheral nerve damage or pelvic infection or other serious complications. The mean operation time was (57.6 ± 17.3) min. The average intraoperative blood loss was (590 ± 570)mL . One hundred and twenty-six patients (12.38%, 126/1018) were given blood transfusion, with an average of (630 ± 450) mL. The average hospital stay was (6.4 ± 4.2) d, the average fetal radiation exposure time was (5.1 ± 1.4) s, and the average dose was (4.0 ± 2.6) mGy in 1018 cases. Neonatal Apgar scores were (9.2 ± 0.4) at 1 min and (9.6 ± 0.3) at 5 min. During follow-up until May 31, 2019, 38 cases were lost to follow-up, 137 were in lactation, and 843 had recurrent menstruation. Except for 38 cases lost to follow-up, the remaining 982 surviving newborns (including 2 twins) showed no abnormalities in the 42-days postnatal outpatient follow-up examination.

Balloon occlusion of abdominal aorta combined with cesarean section is a safe and effective method for the treatment of pernicious placenta previa,which can reduce the risk of hysterectomy, decrease intraoperative blood loss, and have no adverse effects on pregnant women or newborns.