环子宫下段缝合术治疗凶险性前置胎盘伴胎盘植入性疾病的临床疗效

Clinical Effect of Suture of Lower Segment of Uterus in the Treatment of Dangerous Placenta Previa with Placenta Accreta

目的探讨环子宫下段缝合术治疗凶险性前置胎盘伴胎盘植入性疾病的临床效果。方法以2016年1月—2020年8月到该院收治的52例凶险性前置胎盘伴胎盘植入性疾病患者为研究对象,按照患者住院的前后顺序分为两组,前26例患者为观察组,实施环子宫下段缝合术进行治疗,后26例患者设为对照组,实施传统手术方式进行治疗,对比两组临床指标、妊娠结局以及新生儿结局的情况。结果观察组出血量、输血量显著少于对照组,手术时间和住院天数显著短于对照组,差异有统计学意义(P<0.05);观察组子宫切除、转ICU率分别为0.00%、0.00%,显著少于对照组23.08%、26.92%,差异有统计学意义(χ^2=4.710、5.943,P<0.05)。观察组1 min Apgar评分、5 min Apgar评分、出生时体重为(7.89±0.03)分、(9.98±0.04)分、(3.05±0.35)kg明显高于对照组(7.25±1.09)分、(9.25±1.21)分、(2.78±0.34)kg,差异有统计学意义(t=2.993、3.075、2.821,P=0.004、0.003、0.007)。结论对凶险性前置胎盘伴胎盘植入性患者采用环子宫下段缝合术进行治疗,能够减少术中的出血量、输血量,缩短患者的手术时间和住院天数,改善妊娠和新生儿结局。

Objective To investigate the clinical effect of suture of lower segment of uterus in the treatment of dangerous placenta previa with placenta accreta.Methods 52 cases of dangerous placenta previa with placenta accreta disease who were admitted to the hospital from January 2016 to August 2020 as the research objects were divided into two groups according to the order of hospitalization.The first 26 patients were the observation group.The lower uterine segment was sutured for treatment.The last 26 patients were set as a control group and treated with traditional surgical methods.The clinical indicators,pregnancy outcomes and neonatal outcomes were compared between the two groups.Results The amount of bleeding and blood transfusion in the observation group was significantly less than that of the control group,and the operation time and hospital stay were significantly shorter than those in the control group,the difference was statistically significant(P<0.05);the observation group's hysterectomy and transfer to ICU rates were 0.00%and 0.00%,respectively,significantly less than the control group 23.08%,26.92%,the difference was statistically significant(χ^2=4.710、5.943,P<0.05).The observation group's 1 min Apgar score,5 min Apgar score,and birth weight were(7.89±0.03)points,(9.98±0.04)points,(3.05±0.35)kg were significantly higher than those of the control group(7.25±1.09)points,(9.25±1.21)points,(2.78±0.34)kg,the difference was statistically significant(t=2.993、3.075、2.821,P=0.004、0.003、0.007).Conclusion The treatment of patients with dangerous placenta previa with placenta accreta can reduce blood loss and blood transfusion during the operation,shorten the operation time and hospital stay,and improve pregnancy and neonatal outcomes.