【摘要】 目的:探讨低位腹主动脉血管外阻断术治疗前置胎盘效果及对患者应激反应指标、色素上皮衍生因子(PEDF)和血管内皮生长因子(VEGF)影响。方法:选取本院2017年1月-2019年1月收治的前置胎盘患者98例,随机分为对照组和观察组各49例。对照组采用常规出血预防措施,术后采用子宫动脉结扎、纱条填塞、水囊压迫、缩宫素等治疗,观察组采用低位腹主动脉血管外阻断术治疗。比较两组术中相关指标、应激反应指标、PEGF和VEGF水平、新生儿Apgar评分及并发症。结果:观察组出血量、输血量、手术总时间、住院时间、手术操作时间均低于对照组,新生儿娩出后1 min、5 min、10 min的Apgar评分均高于对照组,术后PEGF水平高于对照组、VEGF水平低于对照组,术后去甲肾上腺素(NE)、血清醛固酮(ADS)水平低于对照组,并发症发生率(16.3%)低于对照组(34.7%)(均P<0.05)。结论:低位腹主动脉血管外阻断术治疗前置胎盘患者,能有效改善手术相关指标,提高新生儿身体状况评分,降低应激反应,上调PEGF指标,抑制VEGF水平,减少不良反应的发生。更多还原

【Abstract】 Objective: To investigate the effect of low abdominal aortic extravascular occlusion for treating pregnant women with placenta previa, and to study its influence on their stress response index, pigment epithelium derived factor(PEDF) level, and vascular endothelial growth factor(VEGF) level. Methods: 98 pregnant women with placenta previa were randomly divided into two groups(49 cases in each group) from January 2017 to January 2019. The women in the control group had received the routine precautionary measures for bleeding, such as uterine artery ligation, gauze packing, water sac compression, oxytocin treatment after the operation, while the women in the observation group had received the low abdominal aortic extravascular occlusion for preventing bleeding. Relevant intraoperative indicators, stress response indicators, PEGF and VEGF levels, neonatal Apgar score, and complications of women were compared between the two groups. Results: The blood loss, blood transfusion volume, total operation time, hospitalization time, and operation time of women in the observation group were significant lower than those of women in the control group, but Apgar scores of newborn 1 min, 5 min and 10 min after birth in the observation group were significant higher than those of newborn in the control group(P<0.05). After operation,the PEPF level of women in the observation group was significant higher than that of women in the control group, but the levels of VEGF, NE and ADS of women were significant lower(P<0.05). The incidence of complications of women in the observation group was 16.3%, which was significant lower than that(34.7%) of women in the control group(P<0.05). Conclusion: Low abdominal aortic extravascular occlusion for treating pregnant women with placenta previa can effectively improve operation related indicators, improve neonatal Apgar score, reduce stress response, up-regulate PEGF index and inhibit VEGF level, and reduce adverse reactions.更多还原