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目的:探讨完全穿透性凶险型前置胎盘的临床诊断和治疗。方法:选取我院完全穿透性凶险型前置胎盘患者共10例(研究组),另选普通前置胎盘患者共10例(对照组),分别予以不同的诊断和治疗处理,对比2组患者的手术时间、术中出血情况以及ICU转入、输血、子宫切除、胎盘植入情况。结果:研究组10例患者均顺利分娩,母婴健康出院。对照组术中出血量平均值为(1806.4±142.8)ml、手术平均时间为(89.3±8.4)min,研究组术中出血量平均值为(794.6±106.1)ml、手术平均时间为(68.7±1.9)min,两组出血量及手术时间对比有明显差异(P<0.05)。对照组患者ICU转入1例(10.0%)、输血4例(40.0%)、子宫切除0例(0.0%)、胎盘植入1例(10.0%),研究组患者对照组患者ICU转入3例(30.0%)、输血10例(100.0%)、子宫切除2例(20.0%)、胎盘植入6例(60.0%),两组患者ICU入住、输血、子宫切除、胎盘植入比率有明显差异(P<0.05)。结论:完全穿透性凶险型前置胎盘术中出血量较大、手术时间较长,ICU入住、输血、子宫切除、胎盘植入比率较高,及时、准确的诊断和科学的治疗是保全母婴健康的关键。
Objective: To investigate the clinical diagnosis and treatment of completely penetrating dangerous placenta previa. Methods: Ten patients (study group) with totally penetrating precancerous placenta previa and 10 patients with normal placenta previa (control group) were selected and treated respectively with different diagnosis and treatment, compared with two groups Patient’s operation time, intraoperative bleeding and ICU transfer, transfusion, hysterectomy, placenta accreta. Results: All the 10 patients in the study group were delivered successfully and the mother and child were discharged healthily. The average amount of bleeding in the control group was (1806.4 ± 142.8) ml and the average operation time was (89.3 ± 8.4) min. The average blood loss in the study group was (794.6 ± 106.1) ml and the mean operative time was (68.7 ± 1.9) min, there was a significant difference between the two groups in bleeding volume and operation time (P <0.05). One patient (10.0%), four patients (40.0%) transfused, 0 (0.0%) hysterectomy, and 1 patient (10.0%) underwent ICU were transferred into the control group. (30.0%), transfusion in 10 cases (100.0%), hysterectomy in 2 cases (20.0%) and placenta accreta in 6 cases (60.0%). The rates of ICU transfusion, hysterectomy and placenta accretion in both groups were significant Difference (P <0.05). Conclusions: Completely penetrating dangerous placenta previa placenta was associated with larger amount of bleeding, longer operation time, higher rates of ICU admission, blood transfusion, hysterectomy and placenta accreta. A timely and accurate diagnosis and scientific treatment were necessary for the preservation of mother Baby health key.