胎盘边缘阿氏切口联合子宫动脉上行支结扎术的临床研究

Clinical study on the placental edge incision and ligation of rise in the uterine artery

目的探讨凶险性前置胎盘剖宫产时,胎盘边缘阿式切口联合子宫动脉上行支结扎术对术中出血的影响。方法对60例凶险性前置胎盘剖宫产手术分娩的患者,随机分成两组,每组30例。研究组:剖宫产时取胎盘边缘阿氏切口,联合子宫动脉上行支结扎术,统计术中出血量;对照组:剖宫产时取单纯胎盘边缘阿氏切口,切开子宫,统计术中出血量。结果研究组30例患者中,有23例出血<400 mL。仅1例出血大于800 mL,而对照组中30例患者中10例出血大于400 mL,有7例出血大于800 mL,其中2例因出血较多行子宫切除术。两组宫产术中出血的多少差异有统计学意义(P<0.05)。结论凶险性前置胎盘剖宫产术,选择胎盘边缘阿氏切口,联合子宫动脉上行支结扎术能有效减少术中出血量,是凶险性前置胎盘剖宫产术中一种重要手术方法。

objective to explore the effect of placental margin - type incision combined with uterine artery upstream on intraoperative bleeding in the case of dangerous prcplacental placenta section. Methods A analysis was performed on 60 patients with preclinical placenta cesarean delivery. Patients were randomly divided into two groups, 30 cases in each group. Patients in the study group were treated by caesarean section with placental margin - type incision combined with uterine artery upstream, counting blood loss. Patients in the control group were treated by a simple incision in the margin of the placenta, counting blood loss. Results In the 30 patients of the study group, 23 eases of blood loss are less than 400ml. Only one case of blood loss is more than 800ml. While, in the 30 patients of the control group, 10 cases of blood loss are more than 400ml, and 7 cases of blood loss are more than 800ml, including 2 cases with hysterectomy due to severe bleeding.The difference between the two groups was statistically significant （P 〈0.05）. Conclusion placental margin - type incision combined with uterine artery upstream using in the case of dangerous preplacental placenta section can effectively reduce the amount of intraoperative blood loss. Therefore,placental margin - type incision combined with uterine artery upstream is the preferred surgical approach to preclinical placenta cesarean section.