Gauri Bapayeva, Gulzhanat Aimagambetova, Nazira Kadroldinova, Viktor Zemlyanskiy, Kuat Kassymbek, Milan Terzic
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引用次数: 0
摘要
导言:产科出血是全球孕产妇死亡和发病的主要原因之一。产科出血的主要风险因素之一包括前置胎盘和胎盘早剥谱系(PAS)疾病。前置胎盘和胎盘早剥(PAS)的发生率在全球范围内呈上升趋势,并伴随着术中大出血和失血性休克,剖宫产率也在不断上升。为了降低出血风险,过去十年间,人们对各种血管内球囊闭塞方法进行了试验:本研究旨在评估主动脉血管内球囊闭塞复苏术(REBOA)在减少剖宫产术中失血和保护生殖器官方面的有效性。研究设计:这是一项前瞻性随机对照试验,涉及哈萨克斯坦一家三级产科中心的 144 名患者。研究对象将包括因前置胎盘并发 PAS 疾病而接受剖宫产手术的孕妇。研究对象将被随机分为干预组和对照组:结果:将通过测量主要结果(剖宫产术中的失血量)和次要结果(剖宫产术中子宫切除术的发生率、输血量、手术时间、球囊应用时间、重症监护室(ICU)停留时间、新生儿结局、并发症和术后住院总天数)进行分析:使用 REBOA 可最大限度地减少剖宫产术中的失血量,降低输血成分的需求,缩短手术时间,降低产妇并发症发生率,降低剖宫产子宫切除率。
Effectiveness of aortic balloon occlusion in reducing blood loss during cesarean section in placenta accreta spectrum disorders: a study protocol for a randomized controlled trial.
Introduction: Obstetric hemorrhage is one of the leading causes of maternal mortality and morbidity worldwide. One of the major risk factors of obstetric hemorrhage include placenta previa and placenta accreta spectrum (PAS) disorders. The frequency of PAS disorders is increasing worldwide and is accompanied by massive intraoperative bleeding with hemorrhagic shock and increasing rates of cesarean hysterectomy. To decrease the risks of bleeding, various approaches to endovascular balloon occlusion have been tested during the past decade.
Objectives: This study aimed to evaluate the effectiveness of resuscitative endovascular balloon occlusion of the aorta (REBOA) in reducing blood loss and preserving the reproductive organs during cesarean section. Study design: This will be a prospective randomized controlled trial involving 144 patients in a tertiary care obstetric center in Kazakhstan. The study population will consist of pregnant women who will be admitted for cesarean section due to placenta previa complicated by PAS disorders. The study subjects will be randomly divided into intervention and control groups.
Results: The results will be analyzed through the measurement of primary (blood loss during cesarean section) and secondary outcomes [occurrence of hysterectomy during cesarean section, blood transfusion volume, duration of surgery, balloon application time, stay in intensive care unit (ICU), neonatal outcomes, complications, and total days of postsurgical hospital stay].
Conclusion: The use of REBOA is expected to minimize intraoperative blood loss during cesarean section, decrease the need for transfusion of blood components, reduce the time of surgical intervention, decrease the rate of maternal complications, and reduce the rate of cesarean hysterectomy.
期刊介绍:
Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate
- the use of patient-reported outcomes under real world conditions
- the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines
- the scientific bases for guidelines and decisions from regulatory authorities
- access to medicinal products and medical devices worldwide
- addressing the grand health challenges around the world