胎盘边缘切口在凶险型前置胎盘剖宫产术中的应用效果评价

Application of placental edge incision in caesarean section of pernicious placenta praevia

目的：探讨凶险型前置胎盘剖宫产术中应用胎盘边缘切口的临床效果。方法采用回顾性研究方法分析2009年1月～2014年1月在郴州市第一人民医院产科住院并行剖宫产手术的凶险型前置胎盘患者65例，其中38例采用胎盘边缘切口（研究组），27例采用子宫下段横切口（对照组），比较两组术中出血量、手术时间、输血及子宫切除等情况。结果与对照组比较，研究组的术中出血量明显减少（ P ＜0．05）；两组手术时间比较差异无统计学意义（ P ＞0．05）。研究组术中输血2例，子宫切除1例，对照组术中输血9例，子宫切除5例，研究组的术中输血率、子宫切除率明显少于对照组（ P ＜0．05）。结论在凶险型前置胎盘剖宫产术中应用胎盘边缘切口可以有效地减少患者术中出血量，减少输血及子宫切除率。

Objective To study the clinic effect of placental edge incision in cesarean of pernicious placenta praevia （PPP ） .Methods 65 patients with PPP were selected from Jan .2009 to Jan .2014 and among them 38 were operated by placental edge incision （research group ） and 27 by lower uterine segment transverse incision （control group ） .The quantity of bleeding ,transfusion blood ,the time of operation and the percentage of hyster-ectomy were compared respectively .Results The blood loss in the research group was significantly less than in the control group （ P 〈0 .05 ） .The difference of average operative time between two groups was not statistically sig-nificant （ P 〉0 .05 ） .Two cases in the research group had blood transfusion during surgery ,and one had a rou-tine hysterectomy .While in the control group ,nine cases had intraoperative blood transfusion ,and five had a rou-tine hysterectomy .The hysterectomy and blood transfusion rates in the research group were significantly less than those in the control group （ P 〈0 .05 ） .Conclusion In pernicious placenta praevia cesarean , the application of placental edge incision could effectively reduce blood loss and decrease the blood transfusion and uterine loss rates .