Effect of prophylactic placement of internal iliac artery balloon catheters on outcomes of women with placenta accreta: an impact study
Effect of prophylactic placement of internal iliac artery balloon catheters on outcomes of women with placenta accreta: an impact study
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预防性放置髂内动脉球囊导管对植入性胎盘女性结局的影响：一项影响研究
DOI：
10.1111/anae.13895
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发表时间：
2017-07-01
期刊：
影响因子：
10.7
通讯作者：
Huang, H.
中科院分区：
文献类型：
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作者：
Feng, S.;Liao, Z.;Huang, H.
我们进行了一项关于常规置入髂内动脉球囊导管治疗胎盘植入女性剖宫产术中出血的影响研究。我们确定了11名妇女，产前诊断胎盘植入/植入/渗透，在实践中，作为对照组，和30名妇女髂动脉球囊放置。27例球囊充盈。对照组的中位（IQR [范围]）术中失血量为1100（800-2600 [500-6000]）ml，而髂动脉球囊女性患者为1000（600-2513 [400-15000]）ml（p = 0.64）。6例（54%）对照组接受了术中输血，而14例（47%）髂动脉球囊女性接受了术中输血（p = 0.66）。在3例（27.3%）对照组和13例（43.3%）髂动脉球囊扩张组女性中进行了剖腹子宫切除术（p = 0.48）。球囊导管插入与术后住院时间缩短相关，对照组为6天（5-7 [4-12]天），髂动脉球囊组为5天（4-6 [3-10]天）（p = 0.033）。在6例（54%）对照组中使用全身麻醉，但所有女性均使用髂动脉球囊。本研究表明，预防性髂内动脉球囊闭塞并未减少接受剖腹产的胎盘植入女性的术中出血或剖腹子宫切除术。此外，它对麻醉技术的选择也有重要影响。
We performed an impact study on the introduction of routine placement of internal iliac artery balloon catheters for the management of haemorrhage during caesarean section in women with placenta accreta. We identified 11 women, with prenatally diagnosed placenta accreta/increta/percreta before this change in practice, who acted as controls, and 30 women who had iliac artery balloons placed. The balloons were inflated in 27 cases. The median (IQR [range]) intra‐operative blood loss was 1100 (800–2600 [500–6000]) ml in controls, compared with 1000 (600–2513 [400–15000]) ml in women with iliac artery balloons (p = 0.64). Six (54%) controls received intra‐operative blood transfusion compared with 14 (47%) women with iliac artery balloons (p = 0.66). Caesarean hysterectomy was performed in 3 (27.3%) controls and 13 (43.3%) women with iliac artery balloons (p = 0.48). Balloon catheter insertion was associated with a shortened postoperative hospital stay, 6 (5–7 [4–12] days in controls vs. 5 (4–6 [3–10]) in the iliac artery balloon group (p = 0.033). General anaesthesia was used in six (54%) controls, but all women with iliac artery balloons. This study demonstrates that prophylactic balloon occlusion of the internal iliac arteries did not reduce intra‐operative haemorrhage or caesarean hysterectomy in women with placenta accreta undergoing caesarean section. In addition, it has a significant impact on the choice of anaesthetic technique.