Postpartum hemorrhage is considered to be a serious complication in patients with pernicious placenta. Approaches employing abdominal aortic balloon occlusion to control hemorrhage are extremely effective for such patients. The present study analyzed 9 patients with pernicious placenta previa in a single hospital from June 2016 to November 2017. Prior to cesarean hysterectomy, an abdominal aortic balloon catheter was placed in all patients. The balloon was inflated and evacuated alternately using saline following delivery of the fetal head. The X-ray dose, bleeding volume and complications during the procedure were observed. Balloon catheterization was successfully performed in all 9 patients. The dose of X-rays ranged from 15.8 to 24.5 mGy, with a mean of 19.3±2.7 mGy; the volume of blood loss ranged from 50 to 4,000 ml, with a mean of ~1,800 ml. Uterine artery embolization was successfully performed in 2 cases due to bleeding following the cesarean hysterectomy, and every uterus was retained. Abdominal aortic balloon occlusion can effectively reduce the amount of bleeding during cesarean hysterectomy in patients with pernicious placenta previa. This may serve as technical support for patients in whom retention of the uterus is expected. However, it is necessary to identify any abnormal uterine tissue above the level of the renal artery in order to avoid ineffective balloon occlusion. Patients and methodsPatients. The present retrospective study was conducted among women with pernicious placenta previa accreta/increta who were treated in The First Affiliated Hospital of Anhui Medical
Background: Percutaneous biliary drainage (PTBD) is a palliative treatment for malignant biliary obstruction. The present study adopted different methods of fixing the drainage tube, aiming to evaluate the efficacy and complications for patients. Materials and Methods: Total 68 patients with malignant biliary obstruction, enrolled from 2015 May to 2018 March, were randomly divided into two groups to perform PTBD. 34 patients in group A were fixed the drainage tube by using the traditional way and 34 patients in group B by using an ameliorated approach. The clinical success rate, level of direct/indirect bilirubin, complications and quality of life of patients were recorded. Results: PTBD was successfully performed on all 68 patients. The direct and indirect bilirubin levels of all patients were significantly decreased at 1-week and 1-month post-surgery (P<0.001). Compared with group A, the level of direct bilirubin in group B decreased more significantly at 1-month after the operation (P<0.05). The quality of life of patients was improved in the two groups at 1-month after the operation (P<0.001). In addition, the rate of early postoperative complications was 38.24% in group B, which was not significantly different from the rate in group A (41.18%) (P>0.05). However, the complication rate of late postoperative in group B (6/34) was significantly less than complication rate in group A (16/34) (P<0.05). Conclusion: PTBD is an effective method of treating malignant biliary stricture. The ameliorated fixing method for the drainage tube in PTBD effectively decreases the incidence of late complications, further improving patient quality of life.
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