摘要
目的探讨手术治疗凶险性前置胎盘的临床疗效。方法选择2016年1月—2017年12月收治并确诊的凶险性前置胎盘患者69例,分为研究组(n=35)和对照组(n=34),研究组采用宫颈子宫下段环形缝合术+子宫前壁部分切除及修补术治疗;对照组采用常规保守手术治疗方案(B-Lynch缝合、子宫下段“8”字缝合、宫腔填塞、子宫动脉结扎等),比较并分析两组患者术中失血量、输血量、手术时间、子宫切除率,术后不良反应发生率以及患者满意度。结果研究组术中失血量、输血量、手术时间、子宫切除率、ICU转入率、住院时间以及治疗费用均明显少于对照组;研究组无一例子宫切除,对照组中子宫切除4例;研究组术后不良反应发生率与对照组相比明显降低;研究组患者满意度明显比对照组高,均具有显著性差异(P<0.05),比较两组患者子宫愈合率,差异无统计学意义(P>0.05)。结论宫颈子宫下段环形缝合术+子宫前壁部分切除及修补术治疗凶险性前置胎盘并胎盘植入患者,能够有效减少术中出血并可保留子宫,操作方法更简便,安全性高,患者满意度高,不良反应小,ICU转入率低,缩短住院时间,减少治疗费用,为临床治疗治疗凶险性前置胎盘提供了一个新方法。
Objective To investigate the clinical effect of surgical treatment of dangerous placenta previa.Methods 69 patients with dangerous placenta previa were enrolled and diagnosed from January 2016 to December 2017,and were divided into study group(n=35)and control group(n=34).The study group used cervical uterus lower ring suture.Partial resection and repair of the anterior wall of the uterus;the control group used conventional conservative surgical treatment(B-Lynch suture,“8”suture in the lower uterus,uterine cavity tamponade,uterine artery ligation,etc.),and compared and analyzed the two groups of patients Intraoperative blood loss,blood transfusion,operation time,hysterectomy rate,postoperative adverse reaction rate and patient satisfaction.Results The blood loss,blood transfusion,operation time,hysterectomy rate,ICU transfer rate,hospitalization time and treatment cost of the study group were significantly less than the control group;there was no hysterectomy in the study group and 4 cases of hysterectomy in the control group;The incidence of postoperative adverse reactions was significantly lower in the group than in the control group.The satisfaction of the patients in the study group was significantly higher than that in the control group(P<0.05).There was no significant difference in the uterus healing rate between the two groups(P>0.05).Conclusion Lower cervical uterine segment circular suture plus anterior wall excision and repair can effectively reduce intraoperative bleeding and retain uterus in patients with dangerous placenta previa and placenta implantation.The operation method is simpler,patient satisfaction is high,and adverse reactions are small.It provides a new method for clinical treatment of dangerous placenta previa.
作者
郭萍
陈美琴
邓玲
周鹏
姚瑜平
GUO Ping;CHEN Meiqing;DENG Ling;ZHOU Peng;YAO Yuping(Maternal and Child Health Hospital of YiChun,Yichun 336000,China)
出处
《现代医院》
2019年第12期1817-1820,共4页
Modern Hospitals
关键词
凶险性前置胎盘
宫颈子宫下段环形缝合术
子宫前壁部分切除与修补术
产后出血
子宫
Dangerous Placenta Previa
Cervix Inferior Uterine Ring Suture
Partial Resection and Repair of Anterior Wall of Uterus
Postpartum Hemorrhage
Uterus
