凶险型前置胎盘30例围术期临床分析

The clinical analysis of 30 cases with pernicious placenta praevia

目的:探讨凶险型前置胎盘围术期的相关风险和预防措施。方法:收集凶险型前置胎盘30例作为研究组,同期非凶险型型前置胎盘32例作为对照组,分析2组在围术期的术前超声检查情况、术前出血率、术中出血量、胎盘植入率、子宫切除率、术中采取的止血措施、新生儿窒息、术后恢复时间等方面情况。结果:2组在术前超声检查情况上差异有统计学意义(P<0.01);2组术前出血率和新生儿窒息差异均无统计学意义(P>0.05);2组术中出血量、总输血量、术中生命体征不稳定、胎盘植入率、子宫切除率、术中采取的止血措施方面差异均有统计学意义(P<0.01);2组术后体温和住院时间差异均有统计学意义(P<0.01)。术后血红蛋白恢复2组差异无统计学意义(P>0.05)。结论:凶险型前置胎盘围术期风险巨大,需做好多学科协作的抢救措施,保障母婴安全。

Objective：To explore the perioperative risks and preventive measures of pernicious placenta praevia. Methods：Thirty cases with pernicious placenta praevia and 32 cases with non-pernicious placenta praevia were divided into the study group and control group from 2010 to 2013, respectively. The preoperative ultrasound, preoperative bleeding rate, intraoperative blood loss, placenta implantation rate,uterus resection rate,intraoperative hemostatic measures,neonatal asphyxia and postoperative recovery time between two groups were analysed. Results：The difference of preoperative ultrasound in two groups was statistical significance（P〈0. 01）. There was not significant difference in preoperative bleeding rate and neonatal asphyxia between two groups（P〉0. 05）. The differences of intraoperative blood loss,total amount of blood transfusion,intraoperative vital signs placenta implantation rate,uterus resection rate and intraoperative hemostatic measures between two groups were statistically significant（P〈0. 01）. The differences of postoperative body temperature and hospital stay in two groups were statistically significant（P〈0. 01）,and the difference of postoperative hemoglobin recovery in two groups was not statistically significant（P〉0. 05）. Conclusions：The perioperative risk of pernicious placenta praevia is great,which need some collaboration rescue measures of multidisciplinary to ensure the safety of motherhood and infant.