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目的:探讨凶险型前置胎盘围术期管理体系建立后围生期处理要点。方法:以2009~2012年医院产科收治的26例凶险型前置胎盘孕产妇为观察组,以1992~2000年凶险型前置胎盘23例为对照组,回顾性分析近5年来建立凶险型前置胎盘围术期管理体系后凶险型前置胎盘围生期处理进展和成绩。结果:观察组术前胎盘植入诊断率100.0%(26/26例),对照组诊断率65.2%(15/23例),差异有统计学意义(P<0.05)。观察组子宫切除率为38.4%(10/26),对照组为78.2%(18/23),差异有统计学意义(P<0.05)。观察组平均手术出血量为(1 856.21±426.32)ml,对照组为(3 642.45±652.12)ml,差异有统计学意义(P<0.05)。观察组手术时间为(3.41±0.83)h,对照组为(5.26±0.95)h,差异有统计学意义(P<0.05)。观察组输血量为(2 154.23±531.15)ml,对照组为(3 846.45±625.36)ml,差异有统计学意义(P<0.05)。结论:凶险型前置胎盘围术期管理体系建立是良好的围产结局的根本保证。
Objective: To explore perinatal management of perilous placenta accreta management system. Methods: From 2009 to 2012, 26 cases of dangerous placenta previa were enrolled in the obstetrics and gynecology department of the hospital from March to December, and 23 cases of dangerous placenta previa from 1992 to 2000 were taken as the control group. Placenta accreta perioperative management system of perilous placenta previa placenta after treatment progress and achievements. Results: The diagnosis rate of preoperative placenta accreta was 100.0% (26/26 cases) in the observation group and 65.2% (15/23 cases) in the control group, the difference was statistically significant (P <0.05). The hysterectomy rate was 38.4% (10/26) in the observation group and 78.2% (18/23) in the control group, the difference was statistically significant (P <0.05). The mean operative blood loss in the observation group was (1 856.21 ± 426.32) ml and in the control group was (3 642.45 ± 652.12) ml, the difference was statistically significant (P <0.05). The operation time was (3.41 ± 0.83) h in the observation group and (5.26 ± 0.95) h in the control group, the difference was statistically significant (P <0.05). The volume of blood transfusion in the observation group was (2 154.23 ± 531.15) ml and in the control group was (3 846.45 ± 625.36) ml, the difference was statistically significant (P <0.05). Conclusion: Perinatal management of dangerous placenta previa is a good guarantee for perinatal outcomes.