经后路子宫切除治疗穿透性胎盘植入18例临床分析

发布时间：2018-11-01 11:29

【摘要】：目的探讨经后路子宫切除与传统子宫切除术治疗穿透性胎盘植入的手术并发症和术后情况。方法回顾性分析2010年12月至2014年5月在广州医科大学第三附属医院诊断为穿透性胎盘植入并行围产期经后路子宫切除术患者18例,以及传统子宫切除术治疗穿透性胎盘植入患者30例,比较两组孕产妇的一般情况、手术并发症及术后情况。结果同期确诊胎盘植入420例,其中48例因发生危及生命的产后出血,需要行围产期子宫切除术(11.4%)。两组均无一例产妇死亡。经后路子宫切除术组术中无一例发生膀胱损伤;而传统子宫切除术组发生了2例术中膀胱损伤(6.7%);经子宫后路切除术组手术后输血量及ICU入住天数与传统子宫切除术组相比差异有统计学意义(P0.05)。结论相对于传统的围产期子宫切除术,经后路子宫切除术在治疗胎盘植入,尤其是浸润至膀胱的穿透性胎盘植入,可能是更好的手术选择。
[Abstract]:Objective to investigate the postoperative complications of transposterior hysterectomy and traditional hysterectomy in the treatment of penetrating placenta accreta. Methods from December 2010 to May 2014, 18 patients diagnosed as penetrating placenta accreta and perinatal hysterectomy in the third affiliated Hospital of Guangzhou Medical University were analyzed retrospectively. Thirty cases of penetrating placenta accreta were treated with traditional hysterectomy. Results 420 cases of placenta accreta were diagnosed in the same period, of which 48 cases needed perinatal hysterectomy due to life-threatening postpartum hemorrhage (11.4%). There was no maternal death in both groups. No bladder injury occurred in the posterior hysterectomy group, while in the traditional hysterectomy group, bladder injury occurred in 2 cases (6.7%). The amount of blood transfusion and the days of ICU stay in the posterior hysterectomy group were significantly different from those in the traditional hysterectomy group (P0.05). Conclusion compared with the traditional perinatal hysterectomy, transposterior hysterectomy may be a better choice in the treatment of placenta accreta, especially penetrating placenta accreta which infiltrates the bladder.
【作者单位】：广州医科大学第三附属医院广州重症孕产妇救治;广州医科大学第三附属医院广州重症孕产妇救治中心;
【分类号】：R714.462

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