子宫前壁部分切除及修补术治疗凶险性前置胎盘合并胎盘植入的效果  

Partial Resection and Repair of Anterior Uterine Wall of Uterus in the Treatment of Dangerous Placenta Previa With Placenta Implantation

作　　者：丁少容[1] 戴云先[1] DING Shaorong;DAI Yunxian(Department of Obstetrics and Gynecology,Maoming Maternal and Child Health Hospital,Maoming Guangdong 525000,China)

机构地区：[1]茂名市妇幼保健院妇产科,广东茂名525000

出　　处：《中国卫生标准管理》2020年第14期72-74,共3页China Health Standard Management

摘　　要：目的分析剖宫产术中使用子宫前壁部分切除及修补术治疗凶险性前置胎盘合并胎盘植入的效果。方法纳入本院产科自2016年4月—2018年3月收治的凶险性前置胎盘并胎盘植入患者40例为研究组,选择本院产科自2014年4月—2016年3月收治的凶险性前置胎盘并胎盘植入患者36例为对照组。对照组给予B-Lynch缝合、宫腔填塞等传统止血方法,研究组给予子宫前壁部分切除及修补术。比较两组术中出血量、输血量、输血率、术后24 h出血量。统计两组手术时间、子宫切除率、产妇病死率、术后住院花费与时间。结果研究组术中出血量、输血量、术后24 h出血量均少于对照组,手术时间、术后住院时间均短于对照组,输血率、子宫切除率均低于对照组,住院费用低于对照组,差异具有统计学意义(P<0.05)。两组病死率对比,差异无统计学意义(P>0.05)。结论剖宫产术中采用子宫前壁部分切除及修补术治疗凶险性前置胎盘合并胎盘植入可减少术中、术后出血量,避免子宫切除。Objective To analyze the effect of partial anterior wall resection and repair of cesarean section on the treatment of dangerous placenta previa and placenta implantation.Methods 40 patients with severe placenta previa and placenta accreta treated in our obstetric department from April 2016 to March 2018 were included in the study group.The patients admitted in our department from April 2014 to March 2016,36 patients were used as the control group.The control group was given traditional hemostatic methods such as B-Lynch suture and uterine cavity packing.The study group was given partial resection and repair of the anterior uterus.The intraoperative blood loss,blood transfusion volume,transfusion rate,and 24 h postoperative blood loss were compared between the two groups.The operation time,hysterectomy rate,maternal mortality rate,postoperative hospitalization cost and time were calculated in the two groups.Results The amount of intraoperative blood loss,blood transfusion,and blood loss within 24 hours were significantly less in the study group,the operation time and postoperative hospital stay were significantly shorter in the study group,and the transfusion rate and hysterectomy rate were significantly lower in the study group,the hospitalization cost was significantly lower in the study group,and the differences were statistically significant(P<0.05).There was no significant difference in mortality between the two groups(P>0.05).Conclusion The use of partial anterior wall resection and repair of cesarean section for the treatment of dangerous placenta previa and placenta implantation can significantly reduce the amount of intraoperative and postoperative bleeding and avoid hysterectomy.

关 键 词：剖宫产 子宫前壁部分切除及修补术 凶险性前置胎盘并胎盘植入 出血量 子宫切除率 住院时间 住院费用 

分 类 号：R711[医药卫生—妇产科学]