子宫前壁切除及修补术治疗凶险性前置胎盘并胎盘植入的临床探讨

Clinical Study of Anterior Uterine Wall Resection and Repair for Sinister Placenta Previa and Placenta Implantation

目的探讨凶险性前置胎盘并胎盘植入采用子宫前壁切除及修补术治疗的效果。方法方便选取该院2017年3月—2018年3月收治的凶险性前置胎盘并胎盘植入患者50例,根据数字随机法进行分组,分为观察组(子宫前壁切除及修补术治疗)和对照组(传统方式治疗)各25例,对比产后月经紊乱发生率、子宫切除率、输血率、ICU转入率、子宫愈合率、住院费用、住院时间、手术时间、输血量、总失血量。结果观察组总失血量(986.39±253.61)mL、输血量(357.82±310.25)mL、手术时间(73.05±12.21)min、住院时间(4.31±0.46)d、住院费用(8.62±1.86)千元、子宫愈合92.00%、ICU转入4.00%、子宫切除0.00%、输血40.00%、产后月经紊乱4.00%均优于对照组(1861.53±393.68)mL、(945.45±430.26)mL、(105.81±17.58)min、(7.28±1.53)d、(16.03±6.08)千元、60.00%、36.00%、16.00%、60.00%、20.00%,对比差异有统计学意义(t=1.35,1.41,1.37,2.15,3.05,χ2=10.23,8.62,5.45,5.56,4.41,P<0.05)。结论采用子宫前壁切除及修补术治疗凶险性前置胎盘并胎盘植入可有效改善患者临床症状,提升治疗效果,缩短病程,加快康复,减轻患者经济负担,值得推广。

Objective To investigate the effect of anterior wall resection and repair of sinus placenta previa and placenta.Methods Fifty patients with sinister placenta previa and placenta were enrolled in our hospital from March 2017 to March 2018.They were convenient divided into observation group according to the numerical randomization method(pre-uterine wall resection and repair)and the control group(traditional treatment)25 cases,comparing the incidence of postpartum menstrual disorders,hysterectomy rate,blood transfusion rate,ICU transfer rate,uterine healing rate,hospitalization expenses,hospital stay,operation time,blood transfusion volume,total blood loss.Results The total blood loss of the observation group(986.39±253.61)mL,blood transfusion(357.82±310.25)mL,operation time(73.05±12.21)min,hospitalization time(4.31±0.46%)d,hospitalization expenses(8.62±1.86)thousand yuan,Uterine healing 92.00%,ICU transfer 4.00%,hysterectomy 0.00,blood transfusion 40.00%,postpartum menstrual disorder 4.00%were better than the control group(1861.53±393.68)mL,(945.45±430.26)mL,(105.81±17.58)min,(7.28±1.53)d,(16.03±6.08)thousand yuan,60.00%,36.00%,16.00%,60.00%,20.00%,the difference was statistically significant(t=1.35,1.41,1.37,2.15,3.05,χ2=10.23,8.62,5.45,5.56,4.41,P<0.05).Conclusion The use of anterior wall resection and repair for the treatment of dangerous placenta previa and placenta implantation can effectively improve the clinical symptoms of patients,improve the treatment effect,shorten the course of disease,speed up rehabilitation,reduce the economic burden of patients,and it is worth promoting.