51例凶险性前置胎盘的临床分析

发布时间：2018-03-28 02:39

本文选题：前置胎盘　切入点：胎盘植入　出处：《中国妇幼卫生杂志》2016年01期

【摘要】：目的探讨凶险性前置胎盘的诊断、治疗及孕妇年龄、距前次剖宫产时间、产前出血次数与术中出血的关系。方法 2013年12月-2014年12月深圳市妇幼保健院凶险性前置胎盘患者51例,按术中出血情况分为A组(11例,出血量≤1000m L)和B组(40例,出血量1000 m L),回顾性分析51例凶险性前置胎盘的影像学特点及治疗情况,分析两组之间孕妇年龄、距前次剖宫产时间、产前出血次数的差异。结果 1超声检查对前置胎盘诊断的准确率为100%,此次统计中超声检查对胎盘植入诊断率为38.1%,MRI诊断率80.9%。251例凶险性前置胎盘均采用手术治疗,其中2例因不可控制的术中出血行子宫切除,其余49例术中采取有效止血方式预后良好。3孕妇年龄35岁的比率B组高于A组,差异有统计学意义(P0.05),而距前次剖宫产时间、产前出血次数两组比较,差异无统计学意义(P0.05)。结论凶险性前置胎盘术前应通过超声及MRI充分评估其风险性,制定手术方案;高龄孕妇在凶险性前置胎盘手术中出血的风险性增加。
[Abstract]:Objective to investigate the diagnosis, treatment and age of pregnant women with dangerous placenta previa. Methods from December 2013 to December 2014, 51 patients with dangerous placenta previa in Shenzhen Maternal and Child Health Hospital were divided into group A (n = 11) and group B (n = 40). The imaging features and treatment of 51 cases of dangerous placenta previa were analyzed retrospectively. The age of pregnant women and the time from the previous cesarean section between the two groups were analyzed. Results 1 the accuracy of ultrasonography in the diagnosis of placenta previa was 100. In this statistic, the diagnostic rate of placenta accreta was 38.1% and MRI diagnosis rate was 80.9%. 251 cases of dangerous placenta previa were treated by operation. 2 cases underwent hysterectomy because of uncontrollable intraoperative bleeding, and the other 49 cases underwent effective hemostasis. 3 the rate of pregnant women aged 35 years in group B was higher than that in group A (P 0.05), and the time before cesarean section was higher than that in group B (P 0.05). There was no significant difference in the number of antenatal bleeding between the two groups (P 0.05). Conclusion the risk of severe placenta previa should be fully evaluated by ultrasound and MRI before operation. The risk of bleeding in elderly women during severe placenta previa surgery is increased.
【作者单位】：广东省深圳市妇幼保健院;
【分类号】：R714.56

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