摘要
目的探讨胎盘植入的不同诊治方法对妊娠结局的影响。方法回顾性分析中山大学附属第一医院2000-2010年治疗的91例胎盘植入病例,分析产前诊断方法,终止妊娠时机,术中是否完全清除胎盘对妊娠结局的影响。观察指标包括产妇失血量,是否须入住重症监护病房,有无行子宫切除术、术中泌尿道损伤,或再次手术。结果产前提示胎盘植入组术中泌尿道损伤的发生率低于产前未诊断胎盘植入组,差异有统计学意义(P<0.05)。择期手术组产妇24h出血量、泌尿道损伤的发生率均低于急诊手术组,差异有统计学意义(P<0.05)。完全清除胎盘组产褥病率(8.5%,4/47)低于未完全清除胎盘组(26.3%,10/38),差异有统计学意义(P=0.022)。结论产前正确的诊断,计划性终止妊娠,综合分析考虑决定采用根治性手术还是保留生育能力的保守治疗可降低胎盘植入产妇并发症发生率。
Objective To determine which interventions for managing placenta accreta were associated with reduced ma- ternal morbidity. Methods In a retrospective study we reviewed cases of placenta increta between 2000 and 2010. Maternal complications were compared according to antenatal diagnosis of accreta, indications for delivery, and attempts at placental removal. Maternal complications included volume of maternal blood loss, intensive care unit admission, hyster- ectomy, urethral injury in operation and re-operation. Results The incidence of urinary tract injury in suspected accreta group was significantly lower than that of unsuspected accreta group （ P 〈 0. 05）. 24-hour blood loss in scheduled delivery group was less than that of emergency delivery group significantly （ P 〈 0. 05 ）. The incidence of urinary tract injury in scheduled delivery group was significantly lower than that of emergency delivery group （ P 〈 0. 05 ）. Puerperal morbidity in radical treatment groups was lower than that in conservative group significantly （ P = 0. 022）. Conclusion Accurate prenatal diagnosis scheduled delivery with preoperative preparation and proper approach processing the placenta were as- sociated with reduced maternal morbidity in women with placenta accreta.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2011年第10期761-763,共3页
Chinese Journal of Practical Gynecology and Obstetrics
作者简介
电子信箱：juria@163．com
