摘要
目的:探讨多学科协作诊疗模式在穿透性胎盘植入围手术期的应用价值。方法:选取2015年1月—2018年6月于甘肃省妇幼保健院行术前胎盘超声评分诊断为穿透性胎盘植入并在术中确诊的67例孕妇作为研究对象,根据诊疗模式分为专科诊疗组(32例)和多学科协作诊疗组(35例),收集并比较2组患者的一般情况、术中及术后情况。结果:2组孕妇胎盘植入超声评分、年龄、孕次、人工流产次数、剖宫产次数、终止妊娠孕周比较,差异均无统计学意义(均P>0.05)。多学科协作诊疗组术中出血量、术中输血量、手术时间、子宫切除率、膀胱破裂发生率和凝血功能异常发生率均低于专科诊疗组,差异均有统计学意义(均P<0.05)。多学科协作诊疗组术后住院时间、术后发热发生率和住院费用均低于专科诊疗组,差异有统计学意义(均P<0.05);2组在术后24 h出血量、新生儿5 min Agpar评分方面差异无统计学意义(P>0.05)。结论:多学科协作诊疗模式在穿透性胎盘植入围手术期中作用显著,可明显降低术中出血量、术中输血量及术中膀胱破裂、子宫切除和术后凝血功能异常的发生,并有效的节约医疗资源。
Objective:To evaluate the clinical value of multidisciplinary diagnosis and treatment mode in the perioperative period of placenta percreta.Methods:From January 2015 to June 2018,67 cases were diagnosed placenta percreta by prenatal ultrasonic score system and confirmed by intraoperative findings at the Gansu Provincial Maternity and Child Care Hospital.According to the diagnosis and treatment mode,it is divided into two groups:specialized diagnosis and treatment group(32 cases)and multidisciplinary diagnosis and treatment group(35 cases).The general conditions,intraoperative and postoperative conditions were collected and compared between the two groups.Results:There were no significant differences between in the severity of placenta implantation,age,gravidity,number of abortions,number of cesarean section and gestational week of termination between the two groups(all P>0.05).The intraoperative bleeding volume,intraoperative blood transfusion volume,the operation time,hysterectomy rate,bladder rupture rate and coagulation function abnormality rate in the multidisciplinary cooperative diagnosis and treatment group were lower than those in the specialized diagnosis and treatment group,and the differences were statistically significant(all P<0.05).The postoperative hospitalization time,incidence of postoperative fever and hospitalization expenses in the multidisciplinary cooperative diagnosis and treatment group were lower than those in the specialized diagnosis and treatment group,and the differences were statistically significant(all P<0.05).There was no significant difference in 24-hour blood loss after operation and Apgar score 5 minutes after operation between the two groups(P>0.05).Conclusions:Multidisciplinary diagnosis and treatment mode plays a significant role in the perioperative period of placenta percreta,which can significantly reduce the amount of intraoperative bleeding,intraoperative blood transfusion,the occurrence of intraoperative bladder rupture,hysterectomy,reduce the occurrence of postoperative coagulation dysfunction,and effectively save medical resources.
作者
刘小晖
董燕
刘小玲
蒲巍林
刘晓丽
葛君
张玉芳
高丽娜
郝曼
何晓春
LIU Xiao-hui;DONG Yan;LIU Xiaoling;PU Wei-lin;LIU Xiao-li;GE Jun;ZHANG Yu-fang;GAO Li-na;HAO Man;HE Xiao-chun(Department of Obstetrics,Gansu Provincial Maternity and Child Care Hospital,Lanzhou 730050,China)
出处
《国际妇产科学杂志》
CAS
2020年第6期666-669,共4页
Journal of International Obstetrics and Gynecology
基金
甘肃省自然科学基金(20JR5RA135)。
关键词
合作行为
组织和管理
卫生资源
前置胎盘
侵入性胎盘
Cooperative behavior
Organization and administration
Health resources
Placenta previa
Placenta accreta
