子宫前壁切除及修补术在凶险性前置胎盘并胎盘植入治疗中的应用

Application of Anterior Uterine Wall Resection and Repair in the Treatment of Dangerous Placenta Previa and Placenta Implantation

目的评价分析子宫前壁切除及修补术在凶险性前置胎盘并胎盘植入治疗中的临床意义。方法方便选取该院2017年9月-2018年6月确诊的79例凶险性前置胎盘并胎盘植入产妇作为该研究对象,依据随机分层原则分两组,分别为:35例接受传统保守手术治疗者为对照组,44例实施子宫腔前壁切除及修补术患者为观察组,对比不同患者治疗后效果。结果观察组的总失血量(1078.44±451.02)mL、输血量(456.80±264.58)mL、手术时间(74.00±11.12)min、住院时间(4.60±1.15)d与治疗费用(8.48±1.42)千元少于对照组,差异有统计学意义(t=4.545、4.295、9.781、8.717、8.283,P<0.05),观察组子宫切除率(0.00%)、并发症(2.27%)少于对照组,差异有统计学意义(χ^2=6.710、6.73,P<0.05);观察组的新生儿Apgar评分(9.02±0.58)分高于对照组(8.15±0.70)分,差异有统计学意义(t=9.503,P<0.05)。结论子宫前壁切除与修补术应用于凶险性前置胎盘并胎盘植入患者中,可促患者病情早日康复,降低并发症发生率,应用价值显著。

Objective To evaluate and analyze the clinical significance of anterior wall resection and repair in the treatment of dangerous placenta previa and placenta implantation.Methods 79 cases of maternal women with dangerous placenta previa and placenta accreta were diagnosed and convenient selected in the hospital from September 2017 to June 2018 as the study object.They were divided into two groups based on the principle of random stratification:35 cases who received traditional conservative surgical treatment group was the control group,and 44 cases who underwent anterior wall hysterectomy and repair were the observation group.The effects of different patients after treatment were compared.Results The total blood loss in the observation group was(1078.44±451.02)mL,the blood transfusion volume was(456.80±264.58)mL,the operation time was(74.00±11.12)min,the length of hospital stay(4.60±1.15)d,and the treatment cost(8.48±1.42)thousand Less than the control group,the difference was statistically significant(t=4.545,4.295,9.781,8.717,8.283,P<0.05),and the observation group had less hysterectomy rate(0.00%)and complications(2.27%)than the control group,the difference was statistically significant(χ^2=6.710,6.730,P<0.05);apgar score(9.02±0.58)points in the observation group was higher than that in the control group(8.15±0.70)points,the difference was statistically significant(t=9.503,P<0.05).Conclusion The application of anterior wall resection and repair of malignant placenta previa and placenta implantation can promote patients’early recovery,reduce the incidence of complications,and have significant application value.