剖宫产+经子宫后路子宫切除术治疗完全性前置胎盘合并胎盘植入的临床疗效分析

Clinical efficacy analysis of cesarean section + posterior hysterectomy for complete placenta praevia combined with placental accreta

目的 观察分析剖宫产+经子宫后路子宫切除术应用于完全性前置胎盘合并胎盘植入的临床疗效。方法 80例完全性前置胎盘合并胎盘植入患者,根据治疗方式不同分为观察组和对照组,每组40例。对照组患者采用剖宫产+常规子宫切除术治疗,观察组患者采用剖宫产+经子宫后路子宫切除术治疗。对比两组患者手术相关指标(手术用时、术中出血量、术后24 h出血量、术后住院时间)、术后并发症发生情况。结果 观察组患者的手术用时(139.34±8.56)min、术后住院时间(7.64±1.03)d均短于对照组的(174.25±21.28)min、(10.34±1.29)d,术中出血量(220.17±31.52)ml、术后24 h出血量(2134.25±101.25)ml均少于对照组的(287.45±45.17)ml、(2867.47±134.28)ml,差异具有统计学意义(P<0.05)。观察组患者术后并发症发生率为10.00%,低于对照组的35.00%,差异具有统计学意义(P<0.05)。结论 相较于剖宫产+常规子宫切除术,剖宫产+经子宫后路子宫切除术治疗完全性前置胎盘合并胎盘植入的手术用时和术后住院时间均较短,术中及术后24 h出血量均较少,且术后并发症发生率低。

Objective To observe the clinical efficacy of cesarean section + posterior hysterectomy for complete placenta praevia combined with placental implantation. Methods A total of 80 patients with complete placenta previa and placenta accreta were divided into observation group and control group according to different treatment methods, with 40 patients in each group. Patients in the control group were treated with cesarean section+conventional hysterectomy, while patients in the observation group were treated with cesarean section+posterior hysterectomy. The surgery related indexes(operation time, intraoperative blood loss, blood loss at 24 h postoperatively, postoperative hospital stay), and occurrence of postoperative complications of the two groups were compared. Results The operation time(139.34±8.56) min and postoperative hospital stay(7.64±1.03) d in the observation group were shorter than(174.25±21.28) min and(10.34±1.29) d in the control group;the intraoperative blood loss(220.17±31.52) ml and blood loss at 24 h postoperatively(2134.25±101.25) ml in the observation group were less than(287.45±45.17) and(2867.47±134.28) ml in the control group;the differences were statistically significant(P<0.05). The incidence of postoperative complications in the observation group was 10.00%, which was lower than 35.00% in the control group, and the difference was statistically significant(P<0.05). Conclusion Compared with cesarean section + conventional hysterectomy, cesarean section +posterior hysterectomy for complete placenta praevia combined with placental accreta has shorter operation time and postoperative hospital stay, less intraoperative blood loss and blood loss at 24 h postoperatively, and lower postoperative complication rate.