间歇性阻断腹主动脉联合剖宫产治疗凶险性前置胎盘并植入对母婴结局的影响  

Effect of intermittent blocking of abdominal aorta combined with cesarean section on neonatal outcome and maternal hysterectomy rate in treatment of dangerous placenta previa

作　　者：谢志平 杨跃[2] 姜李乐[2] XIE Zhi-ping;YANG Yue;JIANG Li-le(Department of Obstetrics and gynecology,The Second peoples Hospital of Nanyang,Nangang,Henan 473000,China;Department of Obstetrics,Henan Provincial Peoples Hospital,Zhengzhou 450003,China)

机构地区：[1]南阳市第二人民医院妇产科,河南南阳473000 [2]河南省人民医院产科,郑州450003

出　　处：《医药论坛杂志》2022年第1期33-36,共4页Journal of Medical Forum

基　　金：2019年河南省医学科技攻关计划联合共建项目(LHGJ20190595)。

摘　　要：目的研究间歇性阻断腹主动脉联合剖宫产手术治疗凶险性前置胎盘并植入对新生儿结局、产妇子宫切除率的影响。方法选择出88例2020年4月—2021年4月南阳市第二人民医院妇产科收治的凶险性前置胎盘并植入产妇,现以手术方案进行分组,单行剖宫产术为对照组(n=44),行间歇性阻断腹主动脉联合剖宫产手术作为观察组(n=44),对比组间治疗结果。结果观察组的手术时间、术中出血量及住院时间明显低于对照组(P<0.05,t=39.855,t=194.758,t=7.394);观察组新生儿1 min、5 min的Apgar评分高于对照组(P<0.05,t=5.924,t=7.410);而观察组产妇的子宫切除率与对照组相比则明显降低(P<0.05,χ^(2)=4.950),且观察组的术后并发症发生率也明显低于对照组(P<0.05,χ^(2)=6.064)。结论间歇性阻断腹主动脉联合剖宫产术用于凶险性前置胎盘并植入产妇的治疗手术时间更短,手术创伤更小,可有效提高新生儿出生质量,降低产妇的子宫切除率,促进产妇的术后恢复,建议临床积极推广。Objective To study the effect of intermittent blocking of abdominal aorta combined with cesarean section for dangerous placenta previa implantation on neonatal outcome and maternal hysterectomy rate.Methods A total of 88 cases of pregnant women with dangerous placenta previa were selected from our hospital from April 2020 to April 2021. The selected surgical cases were divided into groups, single cesarean section was control group(n=44), intermittent blocking of abdominal aorta and cesarean section was Observation group(n=44), and the treatment results were compared between the two groups.Results Compared with control group, the operative time, intraoperative blood loss and hospital stay in the observation group were significantly lower, P<0.05(T=39.855, T=194.758, T=7.394). The Apgar score at 1 min and 5 min in the observation group was significantly higher than that in the control group, P<0.05(t=5.924, t=7.410). The rate of hysterectomy in the observation group was significantly lower than that in the control group, P<0.05(χ^(2)=4.950), and the incidence of postoperative complications in the observation group was significantly lower than that in the control group, P<0.05(χ^(2)=6.064).Conclusion Intermittent blocking of abdominal aorta combined with cesarean section for the treatment of dangerous placenta previa and placenta previa implantation is shorter and less surgical trauma, which can effectively improve the birth quality of newborn babies, reduce the rate of hysterectomy of puerpera, and promote the postoperative recovery of puerpera. It is suggested to be actively promoted in clinical practice.

关 键 词：间歇性阻断腹主动脉 剖宫产术 凶险性前置胎盘 胎盘植入 子宫切除 

分 类 号：R719.8[医药卫生—妇产科学]