凶险性前置胎盘患者子宫切除的相关因素研究

Related factors of hysterectomy in patients with pernicious placenta previa

目的研究凶险性前置胎盘(PPP)患者子宫切除的相关因素。方法回顾分析本院2018年1月至2019年1月收治的86例PPP行手术患者,有37例患者行子宫切除,49例患者子宫保留。对86例患者一般资料进行收集,分析PPP行子宫切除因素。其中包括剖宫产次数、合并慢性疾病、孕周等相关因素。结果86例患者均行手术,依据手术记录发现有37例(43.02%)患者实行子宫切除术,49例(56.98%)患者成功保留子宫;子宫切除与年龄、有无HDP、有无GDM无关(P>0.05);与剖宫产次数、术前介入干预、胎盘因素、有无保胎史有关(P<0.05)。结论影响子宫切除因素较多,胎盘植入较为严重的PPP患者决定行子宫切除术前要充分考虑患者一般情况,做好充足准备,避免发生意外,对医疗条件较好的医院要积极推行术前介入干预,以此降低PPP患者子宫切除风险,提高安全性。

Objective:To study the related factors of hysterectomy in patients with pernicious placenta previa(PPP).Methods:A retrospective analysis of 86 cases of PPP patients in our hospital from January 2018 to January 2019,37 cases of patients underwent hysterectomy,49 cases of patients with uterine preservation.The general data of 86 patients were collected and the factors of PPP hysterectomy were analyzed.These factors include the frequency of cesarean section,chronic diseases,gestational weeks and other related factors.Results:86 patients were operated,according to the operation records,37 cases(43.02%)were hysterectomy,49 cases(46.98%)were successfully retained uterus;hysterectomy was not related to age,HDP,GDM(P>0.05);it was related to the number of cesarean section,preoperative intervention,placental factors,and history of fetal protection(P<0.05).Conclusion:There are many factorsaffecting hysterectomy,and the patients with severe placenta accreta should fully consider the general situation of patients before hysterectomy,make adequate preparations to avoid accidents,and actively implement the intervention before operation in hospitals with better medical conditions,so as to reduce the risk of hysterectomy in PPP patients and improve the safety.