Abstract：
OBJECTIVE: To investigate the efficacy of internal iliac artery intraoperative vascular clamp temporary occlusion in the treatment of abnormally invasive placenta.
METHODS: This retrospective study enrolled 153 patients diagnosed with abnormally invasive placenta between January 2018 and December 2021. The patients were divided into a study group (n = 88, undergoing cesarean section followed by internal iliac artery vascular clamp temporary occlusion) and a control group (n = 65, receiving routine cesarean section). The general situation, intraoperative conditions, postoperative complications, and neonatal outcomes were compared between the two groups.
RESULTS: The hysterectomy rate in the study group was significantly lower than that in the control group. However, there were no significant differences in intraoperative blood loss, blood transfusion, postoperative intensive care unit transfer rate, or neonatal outcome between the groups. Further subgrouping showed that in patients with placenta increta, the hysterectomy rate and intraoperative bleeding amount were significantly lower in the occlusion group. Nevertheless, these advantages were not significantly different between the groups in patients with placenta percreta.
CONCLUSIONS: Vascular clamp temporary occlusion of internal iliac artery is an effective method for controlling hemorrhage and decreasing the incidence of hysterectomy in patients with placenta increta. For patients with placenta percreta, the benefit is limited.
METHODS: This retrospective study enrolled 153 patients diagnosed with abnormally invasive placenta between January 2018 and December 2021. The patients were divided into a study group (n = 88, undergoing cesarean section followed by internal iliac artery vascular clamp temporary occlusion) and a control group (n = 65, receiving routine cesarean section). The general situation, intraoperative conditions, postoperative complications, and neonatal outcomes were compared between the two groups.
RESULTS: The hysterectomy rate in the study group was significantly lower than that in the control group. However, there were no significant differences in intraoperative blood loss, blood transfusion, postoperative intensive care unit transfer rate, or neonatal outcome between the groups. Further subgrouping showed that in patients with placenta increta, the hysterectomy rate and intraoperative bleeding amount were significantly lower in the occlusion group. Nevertheless, these advantages were not significantly different between the groups in patients with placenta percreta.
CONCLUSIONS: Vascular clamp temporary occlusion of internal iliac artery is an effective method for controlling hemorrhage and decreasing the incidence of hysterectomy in patients with placenta increta. For patients with placenta percreta, the benefit is limited.
摘要：
目的：探讨髂内动脉术中血管夹临时阻断术治疗胎盘异常侵袭性的疗效。
方法：这项回顾性研究纳入了2018年1月至2021年12月间诊断为异常侵入性胎盘的153例患者。将患者分为研究组（n=88，接受剖宫产，然后进行髂内动脉血管夹临时闭塞）和对照组（n=65，接受常规剖宫产）。总体情况,术中情况,术后并发症,比较两组新生儿结局。
结果：研究组子宫切除率明显低于对照组。然而,术中失血量无显著差异,输血,术后重症监护病房转移率，或两组之间的新生儿结局。进一步的分组显示，在胎盘植入患者中，封堵组的子宫切除率和术中出血量明显较低。然而，这些优势在胎盘穿孔患者的组间没有显著差异.
结论：血管钳暂时阻断髂内动脉是控制胎盘植入患者出血、降低子宫切除术发生率的有效方法。对于胎盘穿孔患者，好处是有限的。
方法：这项回顾性研究纳入了2018年1月至2021年12月间诊断为异常侵入性胎盘的153例患者。将患者分为研究组（n=88，接受剖宫产，然后进行髂内动脉血管夹临时闭塞）和对照组（n=65，接受常规剖宫产）。总体情况,术中情况,术后并发症,比较两组新生儿结局。
结果：研究组子宫切除率明显低于对照组。然而,术中失血量无显著差异,输血,术后重症监护病房转移率，或两组之间的新生儿结局。进一步的分组显示，在胎盘植入患者中，封堵组的子宫切除率和术中出血量明显较低。然而，这些优势在胎盘穿孔患者的组间没有显著差异.
结论：血管钳暂时阻断髂内动脉是控制胎盘植入患者出血、降低子宫切除术发生率的有效方法。对于胎盘穿孔患者，好处是有限的。
