凶险性前置胎盘临床处理流程的探讨

Discussion on clinical Process of Dangerous Placenta Previa

目的探讨凶险性前置胎盘的临床处理流程。方法选择2016年10月至2018年3月在河南科技大学第一附属医院住院治疗的凶险性前置胎盘产妇176例,按不同临床处理方法分为研究组与对照组,研究组按照临床流程处理共106例,对照组急诊住院并手术共70例,对两组的手术出血量、术中红细胞输注量、手术时间、子宫切除率、产后出血率、产褥期病率、新生儿结局等进行分析比较。结果研究组手术出血量、术中红细胞输注量、手术时间、子宫切除率、产褥期病率较对照组明显减少,差异有统计学意义(P<0.05);研究组新生儿阿氏评分、术后血栓形成率较对照组无显著差异(P>0.05)。结论明确诊断并分级,按照临床流程处理凶险性前置胎盘,对凶险性前置胎盘患者减少手术出血量、产后出血、子宫切除率,缩短手术时间、减少产褥期感染等并发症具有重要意义。

Objective To explore the clinical process of dangerous placenta previa.Methods From October 2016 to March 2018 in the First Affiliated Hospital of Henan University of Science and Technology,176 patients with placenta previa were divided into study group and control group according to different clinical treatment methods,in the study group,106 cases were treated according to the clinical procedure,and in the control group,70 cases were hospitalized and operated,the amount of operative bleeding,intraoperative red blood cell transfusion,operation time,hysterectomy rate,postpartum hemorrhage rate,puerperal morbidity and neonatal outcome were analyzed and compared between the two groups.Results The operation bleeding,intraoperative red blood cell transfusion,operation time,hysterectomy rate and puerperal disease rate in the clinical process group were significantly lower than those in the control group(P<0.05),There was no significant difference in neonatal Apgar score and postoperative thrombosis rate between the two groups(P>0.05).Conclusion Definite diagnosis and grading,treating the dangerous placenta previa according to the clinical procedure,reducing the amount of operative bleeding,postpartum hemorrhage and the rate of hysterectomy in the patients with dangerous placenta previa,it is of great significance to shorten the operation time and reduce the puerperal infection and other complications.