子宫修补成形术在凶险性前置胎盘并胎盘植入剖宫产术中的临床应用

Clinical Application of Uterine Repair and Plasty in Caesarean Section with Dangerous Placenta Previa and Placenta Implantation

目的探讨子宫修补成形术在凶险性前置胎盘并胎盘植入剖宫产术中的临床应用效果。方法 2015年12月至2018年3月选择凶险性前置胎盘并胎盘植入患者共91例,设为观察组与对照组,观察组42例,实施子宫修补成形术,与同期49例采用常规手术方案的患者进行比较。比较两组患者的临床效果,并对两组患者产后42d子宫复旧情况进行随访。结果观察组的手术时间、术中出血量、子宫切除率、转入ICU率、DIC的发生率、术后住院时间均明显低于对照组,差异均有统计学意义(P<0.05)。观察组与对照组除子宫切除的病例外,所有产妇子宫切口均愈合良好,均痊愈出院,未发生产妇死亡。产后42d复查彩超提示子宫复旧均良好。结论凶险性前置胎盘并胎盘植入剖宫产术中采用子宫修补成形术,疗效确切,明显减少术中出血量,降低子宫切除率,值得推广应用。

Objective To investigate the clinical effect of uterine repair and plasty in caesarean section with dangerous placenta previa and placenta implantation.Methods From December 2015 to March 2018,91 patients with dangerous placenta previa and placenta implantation were selected as the observation group and the control group,42 patients in the observation group underwent uterine repair and plasty,the results were compared with 49 patients in the same period who underwent routine operation.The clinical effects of the two groups were compared,and the uterine involution of the two groups was followed up 42 days after delivery.Results The operation time,intraoperative bleeding volume,hysterectomy rate,ICU transfer rate,DIC incidence rate and hospital stay in the observation group were significantly lower than those in the control group,the difference were statistically significant(P<0.05).Except for the exceptions of hysterectomy,all the incisions of the uterus in the observation group and the control group were healed and discharged without maternal death.Color Doppler ultrasonography at 42 days postpartum showed that uterus involution was good.Conclusion Uterine repair and plasty is effective in caesarean section with dangerous placenta previa and placenta implantation,it can obviously reduce the amount of bleeding and the rate of hysterectomy,it is worth popularizing and applying.