手术精细化管理对改善前置胎盘剖宫产术不良结局的效果分析

Effect analysis of meticulous preoperative management for improving the outcome of placenta previa cesarean section

目的探讨手术精细化管理措施对改善前置胎盘剖宫术不良结局的效果。方法选择前置胎盘剖宫产术患者235例,将2011~2014年未实施精细化管理的122例作为对照组,2015~2016年实施精细化管理后的113例作为观察组,比较两组患者的术中出血量和子宫切除率情况。结果观察组剖宫产术术中出血量低于对照组(P<0.01);观察组子宫切除率较对照组有所降低,但差异无统计学意义(P>0.05)。结论充分的术前准备及评估、术中完善的抢救流程、积极有效的止血措施,对减少前置胎盘剖宫术术中出血量具有显著效果。

Objective To investigate the effect of meticulous preoperative management on the improvement of outcome of pla- centa previa cesarean section. Methods We selected 235 patients with placenta previa cesarean. We designed 112 patients,who were treated between 2011 and 2014 without the application of meticulous preoperative management, as control group. Another 113 cases be- tween 2015 and 2016 were designed as observation group with the application of preoperative management. The postpartum hemorrhage and the rate of uterectomy were compared between the two groups. Results The amount of postpartum hemorrhage in the observation group was less than that in the control group （ P 〈 0. 01 ）. The rate of uterectomy in the observation group is less than that in the control group, but not reached statistically significant （ P 〉 0. 05 ）. Conclusion It has obvious effect on decrease of amount of postpartum hemorrhage through adequate preoperative assessments, perfection of the rescue process during operation, and effective hemostasis meth- ods.