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目的探讨预防性结扎双侧子宫动脉上行支在中央性前置胎盘剖宫产术中的临床疗效。方法回顾性分析行剖宫产的中央性前置胎盘患者117例临床资料,其中56例术中胎儿娩出后先预防性结扎双侧子宫动脉上行支,然后处理胎盘的为研究组;61例术中胎儿娩出后常规处理胎盘的为对照组,观察两组手术时间、术中出血量、子宫切除率。结果中央性前置胎盘术中出血量与是否合并瘢痕子宫、胎盘植入、前壁胎盘显著相关(P<0.05);研究组术中出血量、手术时间低于对照组,差异有统计学意义(P<0.05),两组子宫切除率差异无统计学意义(P>0.05)。结论预防性结扎双侧子宫动脉上行支在中央性前置胎盘剖宫产术中能有效减少术中出血量,特别适用于合并瘢痕子宫、胎盘植入、前壁胎盘的患者。
Objective To investigate the clinical efficacy of prophylactic ligation of bilateral uterine artery in the cesarean section in central placenta previa. Methods A retrospective analysis of 117 cases of central placenta previa patients with cesarean section clinical data, of which 56 cases of intraoperative fetal prophylactic ligation of bilateral uterine artery upstream branch, and then the treatment of placenta in the study group; 61 cases After the fetus was delivered, the placenta was routinely treated as control group. The operation time, intraoperative blood loss and hysterectomy rate were observed. Results The amount of bleeding during central placenta previa was significantly correlated with the presence of scarring uterus, placenta accreta and anterior wall placenta (P <0.05). The bleeding volume and operative time in study group were lower than those in control group (P <0.05). There was no significant difference in hysterectomy rate between the two groups (P> 0.05). Conclusion Preventive ligation of bilateral uterine artery in the central branch of the uterine artery upstream cesarean section can effectively reduce the amount of bleeding, especially for patients with scar uterus, placenta accreta, anterior placenta.