前置胎盘患者56例剖宫产手术观察

56 Patients with Placenta Previa Cesarean Delivery Operation

目的探讨剖宫手术在前置胎盘治疗中的临床价值。方法选择我院2011年1月至2014年1月妇产科收治入院的进行剖宫产术的56例前置胎盘患者的临床资料进行回顾性分析。分别比较前置胎盘患者的产后出血量、胎盘前置的不同类型以及胎盘的粘连植入情况,观察患者的手术治疗效果。结果在56例前置胎盘患者中,中央型前置胎盘32例,占57.14%;边缘型前置胎盘9例,占16.07%;部分型前置胎盘15例,26.79%。胎盘发生粘连和(或)植入的患者有33例,占58.93%;中央型前置胎盘患者产后出血量明显多于边缘型与部分型前置胎盘患者(P<0.05);56例患者均为剖宫产术,患者均止血成功,有3例患者因产后出血按摩子宫,注射宫缩药物、结扎子宫动脉和髂内动脉均无效而切除子宫,且全为中央型前置胎盘患者,有2例合并胎盘粘连或植入,1例产后肠梗阻。新生儿57例全部存活。早产儿17例。足月儿39例。2例低体质量儿(35^(+4)周,37^(+4)周)。结论剖宫产术是治疗前置胎盘,保证母儿安全的重要方法 。

Objective To study the caesarean section palace in a clinical value in the treatment of placenta previa. Methods Our hospital between January 2011 and January 2014 maternity admitted during the period of cesarean section of the clinical data of 56 patients with placenta previa were retrospectively analyzed. Postpartum haemorrhage amount of patients with placenta previa were compared, the different types of placenta previa and adhesion of the placenta implantation, observe effect of surgical treatment for patients. Results in the 56 patients with placenta previa, central type of placenta previa 32 cases, accounting for 57.14%;borderline placenta previa, 9 cases （16.07%）;some type of placenta previa, 15 cases by 26.79%. Placenta conglutination and （or） of patients implanted with 33 cases, accounted for 58.93%;the central type of placenta previa patients with postpartum haemorrhage amount is more than borderline with some type of placenta previa patients （P〈0.05）;56 cases of cesarean section patients, patients stop bleeding is successful, there are three patients with postpartum hemorrhage of uterine massage, contractions drug injection, uterine artery ligation and iliac artery is void and hysterectomy, and for all patients with central type of placenta previa, with 2 cases and placenta adhesion or implant, 1 case of postpartum intestinal obstruction. Neonatal 57 cases all survived. 17 cases in preterm neonates. The moon has 39 cases. 2 cases of low birth weight （37＋4, 35＋4 weeks）. Conclusion Cesarean section is the treatment of placenta previa, guarantee the security of a mother＇s son.