侧入逆行向上分离膀胱法在凶险型前置胎盘剖宫产术中的应用研究

发布时间：2018-01-15 20:14

本文关键词：侧入逆行向上分离膀胱法在凶险型前置胎盘剖宫产术中的应用研究　出处：《现代妇产科进展》2015年02期 　论文类型：期刊论文

【摘要】：目的:探讨侧入逆行向上分离膀胱法在凶险型前置胎盘剖宫产术中的应用效果。方法:选择2011年1月至2014年7月在江西省妇幼保健院行剖宫产分娩的凶险型前置胎盘可疑胎盘植入者91例。患者在剖宫产术时均需分离膀胱,其中51例采用侧入逆行向上分离膀胱法(研究组),40例采用经子宫前壁向下分离膀胱法(对照组)。比较两组的术中出血量、输血量、平均手术时间、术后平均住院时间、膀胱损伤率、子宫切除率。结果:研究组的平均手术时间、术后平均住院时间、术中出血量、输血量、子宫切除率及膀胱损伤率均低于对照组,差异有统计学意义(P0.05)。结论:侧入逆行向上方法分离膀胱可明显减少凶险型前置胎盘伴胎盘植入剖宫产手术中膀胱损伤,有利于术中出血控制,减少子宫切除率,缩短手术及住院时间。该法操作简单,疗效确切,值得推广应用。
[Abstract]:Objective: to investigate the effect of retrograde upward separation of bladder in the caesarean section of dangerous placenta previa. From January 2011 to July 2014, 91 cases of perilous placenta previa suspected placenta accreta were performed in Jiangxi Maternal and Child Health Hospital by cesarean section. All patients need to separate bladder during cesarean section. Among them, 51 cases were treated by retrograde upward separation of bladder (40 cases of study group were treated with the method of transposition of bladder through anterior wall of uterus) (control group). The volume of blood loss, blood transfusion and mean operation time were compared between the two groups. Results: the average operation time, postoperative hospitalization time, intraoperative blood loss and blood transfusion in the study group. The rate of hysterectomy and bladder injury were lower than those of control group. Conclusion: the method of retrograde upward separation of bladder can significantly reduce the bladder injury during the cesarean section with placenta previa and placenta accreta, which is beneficial to the control of intraoperative bleeding. The rate of hysterectomy is reduced and the operation and hospitalization time are shortened. This method is simple and effective, and is worth popularizing.
【作者单位】：江西省妇幼保健院产科;
【分类号】：R719.8
【正文快照】： 凶险型前置胎盘是指孕妇既往有剖宫产史,此次妊娠胎盘附着于原剖宫产子宫切口疤痕处。临床实践表明,凶险型前置胎盘往往易合并胎盘植入。合并胎盘植入患者的膀胱与子宫前壁,尤其是疤痕处粘连紧密,血运异常丰富,如剖宫产术时没有采取合理方法进行粘连分离,不仅易发生难以控制的

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