宫颈子宫下段环形缝合术在前置胎盘伴胎盘植入剖宫产中的应用效果观察

Application of circular suture in cervical and lower uterine segment in cesarean section for placenta previa complicated by placenta accreta

目的研究宫颈子宫下段环形缝合术在前置胎盘伴胎盘植入剖宫产中的应用效果。方法抽取2016年10月至2020年11月南阳市第一人民医院诊治的82例前置胎盘伴胎盘植入患者,均行剖宫产术。按照手术方式分为观察组(33例)与对照组(49例)。观察组行宫颈子宫下段环形缝合,对照组行常规手术。观察并记录两组围术期指标及母婴结局情况。结果观察组术中出血量、术后住院天数分别为(458.43±61.29)ml、(4.57±1.01)d,少于对照组的(675.24±15.38)ml、(5.38±1.39)d,P<0.05。观察组子宫切除率、切口感染率、产后出血率分别为0.00%(0/33)、3.03%(1/33)、6.06%(2/33),低于对照组的16.33%(8/49)、18.37%(9/49)、22.45%(11/49),P<0.05。观察组新生儿1、5 min Apgar评分分别为(7.75±0.52)、(9.21±0.65)分,高于对照组的(7.13±0.47)、(8.76±0.58)分(P<0.05)。结论宫颈子宫下段环形缝合在前置胎盘伴胎盘植入剖宫产中应用效果较好,可以减少术中出血,缩短住院天数,改善母婴结局。

Objective To investigate the application value of circular suture in cervical and lower uterine segment in cesarean section for placenta previa complicated by placenta accreta.Methods A total of 82 patients with placenta previa complicated by placenta accreta diagnosed and treated in Nanyang First People’s Hospital from October 2016 to November 2020 were enrolled in the study.All 82 patients underwent cesarean section.According to the operation modes,they were divided into observation group(33 cases)and control group(49 cases).The observation group was treated by circular suture in cervical and lower uterine segment,and the control group was treated by conventional surgery.Perioperative indexes,maternal and neonatal outcomes were recorded between the two groups.Results The intraoperative blood loss and postoperative hospital stay in the observation group were(458.43±61.29)ml and(4.57±1.01)d,which were less than(675.24±15.38)ml and(5.38±1.39)d in the control group(P<0.05).The hysterectomy rate,incision infection rate,and postpartum hemorrhage rate of the observation group were 0.00%(0/33),3.03%(1/33)and 6.06%(2/33),respectively,which were lower than 16.33%(8/49),18.37%(9/49)and 22.45%(11/49)of the control group(P<0.05).The 1-and 5-min Apgar scores of neonates of the observation group were 7.75±0.52 and 9.21±0.65,which were higher than 7.13±0.47 and 8.76±0.58 in the control group(P<0.05).Conclusions Circular suture in cervical and lower uterine segment is effective in cesarean section for placenta previa complicated by placenta accreta.It can reduce intraoperative blood loss,shorten the length of hospital stay,and significantly improve maternal and neontal outcomes.