介入溶栓成功治愈预置球囊术在凶险性前置胎盘应用中诱发的动脉血栓

Vascular complications following prophylactic balloon occlusion of the internal iliac arteries resolved by successful interventional thrombolysis in a patient with morbidly adherent placenta*

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摘要目的:球囊预置术的在产科领域的应用缺乏指南规范,该病例分析和文献汇纳分析将为该技术在产科临床应用中的利弊和并发症防治提供参考指导.创新点:首例报道介入溶栓成功治愈预置球囊术在凶险性前置胎盘应用中诱发的动脉血栓.方法:结合病例报道和文献汇纳分析.患者女,25岁,入院诊断:(1)G3P2(1-1-0-1)孕29+2周单活胎,(2)产前出血原因为凶险性前置胎盘,(3)疤痕子宫,(4)先兆早产.孕33周后实施双侧髂内动脉球囊置入术后行子宫下段剖宫产术.剖宫产术后第3天,计算机断层扫描血管造影术(CTA)明确诊断"右髂外动脉血栓,右髂总动脉夹层",立即行数字减影动脉造影(DSA)+介入溶栓术+药物巩固治疗.无并发症出院,随访无后遗症.结论:球囊预置术在胎盘植入中的应用尚无指南遵循,有效性尚存争议,安全性有待明确,需要各中心的数据汇纳和经验集享,以规范该技术的最益化应用.球囊预置术导致血栓形成的并发症处理,需要根据病情及时采取个体化治疗方案:介入溶栓、动脉取栓、药物抗凝、期待治疗或者综合治疗等.

作者单位 Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200126, China ^[1] Department of Interventional Oncolog, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200126, China ^[2] Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY 10032, USA ^[3] Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200126, China ^[4]

关键词球囊导管髂内动脉胎盘植入血管并发症介入溶栓 Baloon catheter Internal iliac artery Placenta accrete Vascular complication Interventional thrombolysis

主题词球囊和椭圆囊(Saccule and Utricle)动脉(Arteries)性(Sex)血栓形成(Thrombosis)前置胎盘(Placenta Previa)

分类号 R714.2

栏目名称 Case Report

发布时间 2017-04-11

基金项目

the Natural Science Foundation of Science and Technology Commission of Shanghai Municipality China

翻译满意度评价：

准确一般字义偏差语意偏离译文作用小提交