凶险型前置胎盘诊疗的探讨

Investiagtion of diagnosis and treatment for dangerous type of placenta previa

目的探讨凶险型前置胎盘的诊断方法和止血方式。方法回归性分析浙江萧山医院2011年1月—2013年1月期间住院分娩的17例凶险型前置胎盘和85例普通型前置胎盘病例的临床特点、诊断方法和止血方式。结果凶险型前置胎盘患者的孕次显著多于普通型(P<0.05);胎盘位置为中央型的比率显著多于普通型;合并胎盘植入率、产后出血率及出血量、子宫切除率、输血人数和输血量均显著高于普通型,差异具有统计学意义(P<0.05)。结论彩色超声多普勒检查诊断凶险型前置胎盘具有准确性高、无创伤、简单易行、对胎儿无影响等优点。根据诊断结果对凶险型前置胎盘合并胎盘植入的孕妇进行准确评估,尽力减少术中或产后出血,以减少子宫切除率,保障产妇的生命安全。

Objective To investigate the diagnoses and hemostasis of pernicious placenta previa. Methods The retrospective analysis of 17 cases of pernicious placenta previa and 85 cases of common type of placenta previa in our hospital from January 2012 to January 2013 conducted. Results The pregnancies in dangerous type of placenta previa patients was significantly higher than that of ordinary type （ P 〈 0.05 ） ; placental location in central rate was significantly higher than that of ordinary type （ P 〈 0.05 ） ; placenta accreta rate, hysterectomy rates, postpartum hemorrhage, postpartum hemorrhage,blood transfusion and transfusion numbers in dangerous type of placenta previa were significantly higher than those of the ordinary type, and the differences were statistically significant （ P 〈 0.05）. Conclusion Color Doppler ultrasound for the diagnosis of placenta previa with dangerous type had the advantages such as high accuracy, non-invasive, simple, no effect on the fetus,etc. According to the accurate results of diagnostic dangerous type of placenta previa with placenta accrete for pregnant women,we should try to reduce intraoperative or postpartum bleeding, reduce the hysterectomy rate, in order to protect the safety of maternal.