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凶险性前置胎盘对妊娠结局的影响及术前管理对母儿预后的改善作用
作者:朱成玲1  王静2 
单位:1. 安康市中医医院 产科, 陕西 安康 725000;
2. 安康市中医医院 妇科, 陕西 安康 725000
关键词:凶险性前置胎盘 妊娠结局 术前管理 预后 
分类号:R714.2
出版年·卷·期(页码):2020·48·第十期(1279-1283)
摘要:

目的:回顾性分析凶险性前置胎盘对妊娠结局的影响并探讨术前管理对改善母儿预后的重要性。方法:选取2015年1月至2017年1月在本院治疗的50例凶险性前置胎盘患者,根据是否伴有胎盘植入分为伴胎盘植入组(24例)和无胎盘植入组(26例)研究凶险性前置胎盘对妊娠结局的影响;根据术前是否进行管理分为择期组(34例)和急诊组(16例)探讨术前管理对母儿预后的改善作用。分析患者术中失血及输血状况,并对比母儿术后并发症发生状况。结果:伴胎盘植入组术中平均失血量显著高于无胎盘植入组(P<0.05),择期组患者术中平均失血量显著低于急诊组患者(P<0.05);伴胎盘植入组产后出血、弥散性血管内凝血(DIC)、失血性休克及产褥期感染发生率显著高于无胎盘植入组,急诊组失血性休克发生率高于择期组(P<0.05)。结论:凶险性前置胎盘发生植入风险较大,伴胎盘植入时出现大出血概率较高,且DIC、失血性休克及产褥期感染等发生率较高,应对患者进行择期手术,提前分娩,降低产后出血风险。

Objective: To retrospectively analyze the influence of pernicious placenta previa on pregnancy outcome and the importance of preoperative management to improve the prognosis of mother and child. Methods: Fifty patients with pernicious placenta previa were enrolled in our hospital from January 2015 to January 2017. They were divided into placenta accreta group(24 cases) and non placenta accreta group(26cases) to explore the effect of pernicious placenta previa on pregnancy outcomes; according to the preoperative management the patients were divided into selective group(34cases) and emergenr group(16cases) to explore the effect of preoperative management on the prognosis of mothers and infants. The blood loss and blood transfusion status of the patients were analyzed, and the postoperative complications of the mothers and infants were compared.Results: The mean blood loss of the placenta accreta group was significantly higher than that of non placenta accreta group(P<0.05). The incidence of postpartum hemorrhage, disseminated intravascular coagulation(DIC), hemorrhagic shock, hysterectomy and puerperal infection in the placenta accreta group were significantly higher than that in non placenta accreta group, and the incidence of hemorrhagic shock in emergent group was higher than that in selective group(P<0.05).Conclusion: The risk of placenta accreta in patients with pernicious placenta previa is high, and the incidence of massive bleeding, DIC, hemorrhagic shock, puerperal infection and hysterectomy is either high. Elective operation must be performed for gain low risk of postpartum hemorrhage.

参考文献:

[1] 陈廷静,罗巧玲,卢蓉,等.凶险性前置胎盘再次剖宫术与介入治疗的风险管理[J].护理学杂志,2017,3(24):35-37.
[2] 魏小华,王雯娟,田改彦,等.凶险性前置胎盘产科与介入镶嵌式治疗模式的围手术期管理研究[J].中国妇幼健康研究,2017,5(20):351-379.
[3] 汪佳慧.凶险性前置胎盘诊断及治疗进展[J].现代妇产科进展,2019,28(1):71-73.
[4] 杨红梅,陈锰,刘兴会.凶险性前置胎盘的围生期管理[J].实用妇产科杂志,2017,33(9):641-643.
[5] 唐毅,冯琼,潘长青.应急预案在凶险型前置胎盘管理中的效果探讨[J].中国妇幼保健,2016,31(16):3234-3237.
[6] 杨静,赵扬玉.凶险性前置胎盘合并胎盘植入的影像学诊断研究进展[J].实用妇产科杂志,2017,11(9):8-11.
[7] WEINER E,MIREMBERG H,GRINSTEIN E,et al.Placental histopathology lesions and pregnancy outcome in pregnancies complicated with symptomatic vs.non-symptomatic placenta previa[J].Early Hum Dev,2016,22(10):85-89.
[8] 刘丽霞.凶险型前置胎盘产后出血诊治分析[J].中国煤炭工业医学杂志,2016,19(1):43-45.
[9] 杨凡.人性化护理干预对前置胎盘患者妊娠结局的影响[J].荷泽医学专科学校学报,2017,29(4):64-66,81.
[10] 张超,王娜,安丽,等.凶险型前置胎盘合并胎盘植入的鉴别诊断及两种动脉球囊预置介入治疗比较[J].河北医药,2018,19(14):310-323.
[11] 李素芬,杨鹰.剖宫产术前子宫动脉置管术中行栓塞术对防治凶险性前置胎盘产后出血的疗效评价[J].第三军医大学学报,2015,37(21):2203-2206.
[12] 戴毅敏,王志群,张雪斌,等.多学科系统化管理在凶险性前置胎盘中的应用研究[J].现代妇产科进展,2015,11(8):561-564.
[13] ARIAN K,AMELA T,ZAMIRA S.Statistical data about risk factors and pregnancy outcome of placenta previa[J].Eur Sci J,2018,14(15):27-33.
[14] 李秀娟,陈淑荣.凶险性前置胎盘的产前预测及临床处理[J].中国妇产科临床杂志,2015,5(5):449-450.
[15] WALFICH A,SHEINER E.Placenta previa and immediate outcome of the term offspring[J].Arch Gynecol Obstet,2016,24(4):739-744.
[16] 李学会,苏建芬,邓东阳.产前超声诊断凶险性前置胎盘并胎盘植入9例分析[J].贵州医药,2015,13(10):930.
[17] 连旭波,韦春杏.妊娠期凶险型前置胎盘的核磁共振成像诊断价值与妊娠结局的关系[J].中国计划生育与妇产科,2018,10(1):28-31.

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