植入型凶险型前置胎盘应用早期结扎双侧子宫动脉上行支的效果分析

Analysis of the effect of early ligation of bilateral uterine arterial ascending branches in implanted dangerous placenta previa

目的探讨植入型凶险型前置胎盘应用早期结扎双侧子宫动脉上行支的效果。方法收集2015年1月至2016年11月入院的80例植入型凶险型前置胎盘患者随机分为两组，对照组患者给予传统8字缝扎＋宫腔填纱布处理，实验组患者则予以早期结扎双侧子宫动脉上行支处理，比较两组患者及其新生儿相关临床参数、Hb水平与相关临床事件。结果实验组患者术中出血量[（845．25±179．45）ml]与术后24h出血量]（1021．15±113．87）ml]均显著低于对照组[（1463．03±406．25）ml，（1502．79±231．70）ml]；Hb水平[（83．76±11．25）g/L]组间比较显著高于对照组[（62．88±13．58）g／L]；输血率（27．5％）、子宫切除率（25％）与产妇转入ICU发生率（12．5％）均显著低于对照组（75％，60％，47．5％），差异有统计学意义（P〈0．01）。结论植入型凶险型前置胎盘应用早期结扎双侧子宫动脉上行支的效果显著，具有借鉴意义。

Objective To investigate the effect of early ligation of bilateral uterine arterial ascending branches in implanted dangerous placenta previa. Methods 80 patients with implanted dangerous placenta previa from January 2015 to November 2016 were randomly divided into two groups. The control group was treated with traditional ＂8＂ suture ＋ gauze packing, while the experimental group was treated with early ligation of bilateral uterine arterial ascending branches. Compared patients＇ and their neonatal clinical parameters, Hb level, and related clinical events of the two groups. Results The intraoperative blood loss and blood loss within 24 hours after surgery in the experimental group were significantly lower than those in the control group [（845.25±179.45）ml vs.（1 463.03±406.25）ml, （1 021.15±113.87）ml vs.（1 502.79±231.70）ml], Hb level was significantly higher than that in the control group [（83.76±11.25）g/L vs.（62.88±13.58）g/L], the rate of transfusion, the rate of hysterectomy, and the rate of mothers transferred to ICU were significantly lower than those in the control group （27.5% vs.75%, 25% vs.60%, 12.5% vs.47.5%）, with statistically significant differences （P〈0.01）. Conclusion Early ligation of bilateral uterine arterial ascending branches has significant clinical effect in implanted dangerous placenta previa, of great significance.