多学科系统化管理在凶险性前置胎盘中的应用研究

发布时间：2018-04-27 09:47

  本文选题：凶险性前置胎盘 + 产后出血　； 参考：《现代妇产科进展》2015年08期

【摘要】：目的:探讨多学科系统化管理凶险性前置胎盘(PPP)对母儿妊娠结局的影响。方法:2013年1月至2015年2月在南京大学医学院附属鼓楼医院住院分娩的PPP孕妇41例,其中经包括自体血贮备、术前核查、髂总动脉球囊预置等内容在内的多学科系统化管理者为系统管理组20例,未接受妊娠期管理者为对照组21例。分析这些病例的母儿妊娠结局。结果:2013年、2014年和2015年1~2月,凶险性前置胎盘分别占同期分娩总数的0.5‰(2/4402)、4.3‰(25/5762)和15.5‰(14/905),发生率大幅迅速增加,差异显著(P0.001)。系统管理组和对照组的产后出血量分别为710ml(230~6000ml)和1500ml(310~4515ml)ml,出血率分别为30.0%和61.9%。系统管理组的产后出血量和出血率均低于对照组(P=0.06,P=0.07);产前自体血贮备量显著增高(P≤0.05),异体浓缩红细胞(RBC)输注量达到或超过4U以上大量输血孕妇明显减少,早期发病率为15.0%,显著低于对照组的52.4%(P≤0.05)。结论:多学科系统化管理流程能减少PPP围术期的严重并发症。
[Abstract]:Objective: to investigate the effect of multi-disciplinary systematic management of dangerous placenta previa (PPP) on maternal and fetal pregnancy outcome. Methods: from January 2013 to February 2015, 41 pregnant women with PPP who were hospitalized and delivered in Gulou Hospital affiliated to Medical College of Nanjing University, including autologous blood reserve, were examined before operation. The systematic management of the common iliac artery included 20 cases in the system management group and 21 cases in the control group. The maternal and fetal outcomes of these cases were analysed. Results: from January to February of 2013, 2014 and 2015, the incidence of dangerous placenta previa accounted for 0.5 鈥，

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