凶险性前置胎盘合并胎盘植入手术治疗方法分析  

The surgical treatment of the placenta with the placenta was investigated

作　　者：刘燕 东保吉[2] 

机构地区：[1]新疆乌鲁木齐市妇幼保健院产科,新疆乌鲁木齐830000 [2]新疆医科大学第六附属医院院感办,新疆乌鲁木齐830002

出　　处：《现代医学与健康研究电子杂志》2017年第5期11-12,共2页Modern Medicine and Health Research

摘　　要：目的研究探讨凶险性前置胎盘合并胎盘植入手术治疗方法。方法将本院2011年8月至2016年8月期间收治的凶险性前置胎盘合并胎盘植入患者200例作为研究对象,回顾分析患者在治疗方案与预后情况。结果本次研究200例患者均行剖宫产手术终止妊娠,其中197例成功手术,子宫得以保留,余下3例患者因胎盘植入导致产后发生难治性出血,经多种方式止血失败后转行子宫切除,未发生死亡;107例患者发生产后出血,失血量在950-8230ml,平均出血量2435.3±376.5ml。其中81例患者采取子宫卵巢血管交通支、双侧髂内动脉及子宫动脉下行支结扎术;116例患者行髂内动脉结扎术联合子宫动脉下行支结扎。结论凶险性前置胎盘植入具有极高的出血风险,易导致失血性休克、弥散性血管内凝血(DIC)等症状,因此需做好各项术前准备,降低术中风险。Objective To study the surgical treatment of placenta previa complicated with placenta accreta. Methods 200 cases of placenta previa complicated with placenta accreta were treated in our hospital from August 2011 to August-2016,and the treatment plan and prognosis of the patients were retrospectively analyzed. Results in this study,200 patients underwent cesarean section termination of pregnancy,including 197 cases of successful surgery,uterine retained,the remaining 3 patients with placenta implantation cause postpartum refractory hemorrhage,through a variety of ways to stop bleeding after the failure to hysterectomy,no death;107 cases of postpartum hemorrhage. The blood loss in the 950-8230 ml,the average amount of bleeding was 2435. 3 + 376. 5ml. Among them,81 patients underwent ligation of uterine and ovarian vascular branches,bilateral internal iliac artery and descending branch of uterine artery. 116 patients underwent ligation of internal iliac artery and ligation of descending branch of uterine artery. Conclusion the dangerous placenta previa implantation has a high risk of bleeding,which can lead to hemorrhagic shock and disseminated intravascular coagulation( DIC),so it is necessary to do all the preoperative preparation and reduce the risk of operation.

关 键 词：凶险性前置胎盘 胎盘植入 手术治疗 产后出血 

分 类 号：R714.2[医药卫生—妇产科学]