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目的分析凶险型前置胎盘对母婴的危害性,探讨临床诊断、处理方法及预后。方法回顾分析22例凶险型前置胎盘患者临床资料,总结凶险型前置胎盘的处理方法及效果。结果 22例患者均以手术终止妊娠,其中择期手术8例,余者均急性大出血而急诊手术终止妊娠。22例患者均发生了产后出血,出血量2000~4500 ml,平均3340 ml,其中8例患者因产后出血、继发弥散性血管内凝血(DIC)行“全子宫切除术”。无生机儿1例,早产20例,足月产1例;窒息5例,其中重度窒息3例、轻度窒息2例。新生儿成活16例,另5例因家属放弃而死亡。22例患者及其家属术后配合治疗,无医疗纠纷发生。结论凶险型前置胎盘对母婴危害性大,需提高警惕,重视预防,术前充分准备以减少母婴并发症的发生。
Objective To analyze the dangers of dangerous placenta previa on mothers and infants, to explore the clinical diagnosis, treatment and prognosis. Methods The clinical data of 22 cases of dangerous placenta previa were retrospectively analyzed, and the treatment methods and effects of dangerous placenta previa were summarized. Results Twenty-two patients underwent surgical termination of pregnancy, of which elective surgery in 8 cases, the remaining were acute bleeding and emergency surgery termination of pregnancy. All of the 22 patients had postpartum hemorrhage, the amount of bleeding was between 2000 and 4500 ml, with an average of 3340 ml. Among them, 8 patients underwent postoperative hemorrhage and secondary disseminated intravascular coagulation (DIC) underwent hysterectomy. 1 case of non-viable children, 20 cases of preterm birth, full-term birth in 1 case; 5 cases of asphyxia, including severe asphyxia in 3 cases, mild asphyxia in 2 cases. 16 newborns survived, and the other 5 died as a result of family abandonment. 22 patients and their families with postoperative treatment, no medical disputes. Conclusion Dangerous placenta previa placenta is very harmful to mothers and infants, so vigilance should be paid more attention to prevention. Preoperative preparation should be sufficient to reduce the incidence of maternal and infant complications.