完全性前置胎盘植入子宫瘢痕的临床治疗分析

Clinical treatment analysis of uterus scar of completely placenta previa increta

目的探讨完全性前置胎盘植入子宫瘢痕的临床治疗经验。方法回顾性分析我院2004年1月～2013年1月收治入院的前置胎盘＋瘢痕子宫伴出血患者共34例,其中11例伴胎盘植入患者的临床资料。结果 11例伴胎盘植入患者术中发现大部分植入9例,1/4面积植入的2例,子宫次切5例,子宫全切2例,手术患者术中至术后2h内出血量介于200～6000m L之间,平均出血量（1571.6±82.3）m L,出院未手术2例,其余（宫腔填塞纱布）2例保守治疗成功,无一例发生死亡。结论胎盘植入是产科严重的并发症,做好产前检查是改善预后的关键,当并发大出血时需行子宫切除术,非急症者可进行保守治疗。

Objective To study the clinical treatment experience of uterus scar of completely placenta previa increta. Methods 34 patients with placenta previa and scar uterus who were treated in our hospital from January 2004 to January 2013 were retrospectively analyzed, thereinto 11 cases of clinical data with placenta increta. Results Of the 11 cases with placenta increta, there were 9 cases with a majority of implantation and 2 cases with 1/4 areas implantation, there were 5 cases subtotal hysterectomy, 2 cases total hysterectomy, 2 cases discharged without operation, 2 cases successful conservative treatment of uterine packing gauze, while the mean blood loss of surgical patients was（1571.6±82.3）m L in the blood loss of（200～6000）m L from intraoperative to 2h after operation. Conclusion The key work of improve prognosis on placenta increta, which is a serious complication in obstetrics, is to do well of prenatal examination. When there was placenta increta concurrent with massive hemorrhage, it＇s better to perform hysterectomy, while non-emergent patients was adopted with conservative treatment.