杂交手术平台在前置胎盘合并胎盘植入患者手术治疗中的临床应用  

Clinical application of hybrid operation platform in treatment of patients with placenta previa and placenta accreta

作　　者：左坤[1,2] 陈德 赵有红 何晓春[1] 杜松[1] 刘青[1,2] 

机构地区：[1]甘肃省妇幼保健院,甘肃兰州730050 [2]甘肃省中医药大学,甘肃兰州730050

出　　处：《中国妇幼保健》2017年第22期5736-5738,共3页Maternal and Child Health Care of China

基　　金：甘肃省科学技术厅医药卫生科技项目(1606RJZA169)

摘　　要：目的探讨杂交手术平台在前置胎盘合并胎盘植入患者手术治疗中的临床应用价值。方法对2012年6月-2015年12月该院产科收治的60例前置胎盘合并胎盘植入且胎盘植入评分为重度患者的病例资料进行回顾性分析。根据治疗方法的不同分为观察组和对照组,杂交手术室进行剖宫产术联合子宫动脉栓塞杂交手术的18例患者为观察组,采用传统剖宫产方法终止妊娠的42例患者为对照组;比较两组患者手术时间、术中出血量、术中及术后输血量、子宫切除率、术后住院时间、新生儿Apgar评分、休克、弥散性血管内凝血(DIC)发生情况。结果观察组术中出血量、术中及术后输血量、住院时间、子宫切除率、休克发生率明显低于对照组(P<0.05);两组手术时间、新生儿Apgar评分、DIC发生率比较,差异均无统计学意义(P>0.05)。结论与传统剖宫产手术方法比较,前置胎盘合并胎盘植入患者在杂交手术室进行剖宫产联合子宫动脉栓塞术可避免不必要的转运,具有减少术中出血量、降低子宫切除率等优点,是一种安全、有效的手术方法。Objective To explore the clinical application value of hybrid operation platform in treatment of patients with placenta previa and placenta accreta.Methods A retrospective analysis on 60 severe cases with placenta previa and placenta accreta in the hospital from June 2012 to December 2015 was performed.According to different treatment methods,these cases were divided into observation group and control group.A total of 18 cases treated by cesarean section combined with uterine artery embolization were selected as observation group,and 42 cases treated by termination of pregnancy by traditional cesarean section were selected as control group.The operation time,intraoperative bleeding volumes,the volumes of intraoperative and postoperative blood transfusion,hysterectomy rates,postoperative hospitalization time,neonatal Apgar scores,incidence rates of shock and disseminated inravascular coagulation（DIC） were compared between the two groups.Results The intraoperative bleeding volume,the volumes of intraoperative and postoperative blood transfusion,hospitalization time,hysterectomy rate,and incidence rate of shock in observation group were significantly lower than those in control group（P〈0.05）.There was no statistically significant difference in operation time,neonatal Apgar score,and the incidence rate of DIC between the two groups（P〈0.05）.Conclusion Compared with conventional cesarean section,cesarean section combined with uterine artery embolization in hybrid operation room can avoid unnecessary transportation of patients with placenta previa and placenta accreta.It is a safe and effective method to reduce the volume of intraoperative bleeding and the incidence rate of hysterectomy.

关 键 词：前置胎盘 胎盘植入 剖宫产 子宫动脉栓塞术 

分 类 号：R719[医药卫生—妇产科学]