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目的探讨钳夹缝扎技术在前置胎盘局部存在胎盘粘连或植入中应用的安全性和有效性。方法 2009年1月至2013年1月中国医科大学附属第一医院产科共分娩4306例产妇,其中前置胎盘82例(发生率1.90%)。排除凶险性前置胎盘、双胎、边缘性前置胎盘及存在其他能引起出血的疾病的孕妇。共纳入64例前置胎盘行剖宫产术术中发现不同程度的部分胎盘粘连或植入的孕妇为研究对象,术中采用奇偶数分组法分为研究组(采用钳夹缝扎技术处理前置胎盘局部粘连或植入处)和对照组(常规处理胎盘粘连或植入),各为32例。比较分析两组孕妇术中及术后情况。结果两组孕妇在血红蛋白减少[(9.4±6.7)g/L、(24.5±8.6)g/L]、手术时间[(51.2±12.1)min、(76.4±20.4)min]、子宫动脉结扎方面差异均有统计学意义(P<0.05)。术后两组均未发生胎盘残留和滋养细胞疾病。结论剖宫产术中采用钳夹缝扎的方法处理前置胎盘粘连或植入的部分安全有效,值得推广。
Objective To investigate the safety and efficacy of the clamp-on suture technique in the local placenta adhesion or implantation in the placenta previa. Methods From January 2009 to January 2013, 4306 maternal women were delivered in the obstetrics department of the First Affiliated Hospital of China Medical University, including 82 cases of placenta previa (incidence 1.90%). Excluding dangerous placenta previa, twins, marginal placenta previa and other bleeding-causing diseases can occur in pregnant women. A total of 64 cases of placenta accreta placenta accreta were found in different degrees of partial placental adhesion or implantation of pregnant women as the research object, the use of parity grouping method was divided into the study group (using clamp suture technology to deal with the front Placenta local adhesion or implantation) and control group (conventional treatment of placental adhesion or implantation), each of 32 cases. Comparative analysis of two groups of pregnant women intraoperative and postoperative conditions. Results The reduction of hemoglobin in the two groups of pregnant women was (9.4 ± 6.7) g / L and (24.5 ± 8.6) g / L, respectively, and the time of operation was (51.2 ± 12.1) min and (76.4 ± 20.4) min, All were statistically significant (P <0.05). No postoperative placental residue and trophoblastic disease occurred in either group. Conclusion Cesarean section in the treatment of placenta accreta adhesion or implantation part of the safe and effective, it is worth promoting.