胎盘植入60例临床分析

目的对胎盘植入患者的病史资料进行回顾性分析,探讨导致胎盘植入的高危发病因素,针对患者病情采取合适的处理方法。方法对确诊的60例胎盘植入患者的病史特点、临床处理方法及结局进行分析研究。结果 60例胎盘植入患者53例采用钳刮、结扎缝合、宫腔放置球囊压迫止血、甲氨蝶呤+米非司酮联合用药治疗、子宫动脉结扎术、子宫动脉栓塞术保守治疗取得满意效果;7例穿透性胎盘植入急性大出血,病情凶险,直接行子宫切除术。结论胎盘植入与多次引流产、剖宫产、宫腔镜操作、前置胎盘、高龄妊娠有关,当患者病情平稳,出血量较少时可以采取保守治疗,而发生急性大出血危及患者生命时,应果断的行子宫切除手术,以确保患者的生命安全。

Objective The medical history of placenta implantation was retrospectively analyzed, and the high risk factors for placenta implantation were discussed, and appropriate treatment methods were taken for the patients. Methods The clinical characteristics, clinical treatment and outcome of 60 patients with placenta implantation were analyzed. Results 53 patients with 60 cases of placenta implantation use clamp scraping, ligation suture, uterine cavity placing balloon compression for hemostasis, methotrexate ＋ mifepristone combination therapy, uterine artery li6ation and mifepristone conservative treatment of uterine artery embolization with satisfactory effect;7 cases of penetrating placenta were implanted with acute hemorrhage, the disease was dangerous, and the hysterectomy was performed. Conclusion Placenta implantation is associated with multiple induced abortion, labor induction, cesarean section, hysteroscopic operation, placenta previa and senile pregnancy. When the patient＇s condition is stable and the amount of bleeding is small, conservative treatment can be adopted, and an acute bleeding may endanger the patient＇s life. The hysterectomy should be performed decisively to ensure the safety of the patient＇s life.