关于中央性前置胎盘的分类及其临床意义的探讨(Ⅰ)

Classification of complete placeta previa (CCP) and clinic significance

目的:研究对中央性前置胎盘(complete placenta previa CPP)的分类和手术切口设计原则,并探讨其临床意义。方法:选择CPP的病人用B超测定胎盘在子宫中的状态,依据胎盘主要附着于子宫后壁、后侧壁、前侧壁和前壁的不同状态,将其分为Ⅰ、Ⅱ、Ⅲ和Ⅳ种类型。同时确定宫颈内口水平线(L线)及与之相垂直的A、B、C3条线,即经内口垂直于L线的A线,与A线相平行且向右左各旁开4cm的B线和C线。3条线与胎盘边缘相交点称为A点、B点和C点,这3点与宫颈内口水平线的距离分别称为A段、B段和C段。不同类型的CPP中,A、B、C3点的连线均为所设计的手术切口线。结果:依据我们的临床分析结果,CPP分类能够很好的指导术前手术切口的设计,B超能够很好的按照临床的要求提供CPP的量化指标。结论:CPP的分类进一步拓展、丰富、细化了前置胎盘的分类,CPP的手术切口设计原则可以满足不同类型CPP的手术需要,具有重要的理论和临床指导意义。

Objective： To explore the classification of complete placeta previa （CCP） and the principle of selection of operating incision in CCP. Methods： CPP was classified to four sorts with the different position of placenta in uterine cavity by B ultrasonic. The four lines were confirmed by B ultrasonic. Horizontal line of cervix os was called L line and A line was vertical of L line. B and C line leaving A line each other 4 cm was also vertical of L line. The points that they crossed placental margin were called the point of A, B and C. The operating incision was the line that connected the three points and was so called Ar＇s incision. Results： The projection of operating incision before operation was primely guidanced by classification of CPP and B ultrasonic provided an ideal index to be qualified according to clinic demand. Conclusion： The classification of CCP extend and enrich the class of placenta previa. The principle of selection of operatng incision may satisfy the need of different operation in CPP and have important theory and clinic signification.