摘要
目的:探讨使用穿刺引流管捆绑子宫下段后行子宫螺旋式缝合术在完全性前置胎盘伴胎盘植入(胎盘植入评分<10分)手术中的临床效果。方法:选择2019年7月至2020年9月在南京医科大学第一附属医院行择期剖宫产的完全性前置胎盘伴胎盘植入(胎盘植入评分<10分)孕妇共13例为研究对象,采用穿刺引流管引导穿刺子宫阔韧带内无血管区捆绑子宫下段辅助下行子宫下段多方位螺旋式缝合术,分析患者术中及术后情况。结果:13例患者手术时间68.54±11.86分钟,一次性穿刺引流管套扎子宫血管阻断时间22.54±8.31分钟,术中出血量496.15±161.33 ml,24小时出血量611.54±160.62 ml,仅1例输血;13例患者术中均未出现膀胱、肠管等周围器官损伤等手术并发症,无子宫切除病例,无产褥感染及晚期产后出血病例,术后住院时间4.69±1.18天。结论:穿刺引流管捆绑子宫下段后行子宫螺旋式缝合术在胎盘植入评分小于10分的完全性前置胎盘手术中,可控制术中大量出血,减少手术并发症,促进产褥期康复,是一种操作简单、安全有效的方法。
Objective:To investigate the clinical effect of drainage tube binding lower uterine segment followed by uterine spiral stitching in the treatment of complete placenta previa combined with placenta increta cases(placenta implantation score<10 points).Methods:A total of 13 pregnant women with complete placenta previa combined with placenta increta(placenta implantation score<10 points)who underwent elective cesarean section in the First Affiliated Hospital of Nanjing Medical University were selected from 2019.7 to 2020.9.Drainage Tube was used to bind the lower segment of the uterus under with the guidance and puncture through the avascular area of the uterine broad ligament.Multidirectional spiral stitching was performed in the lower segment of the uterus.Their intraoperative and postoperative conditions were analyzed.Results:Operation time of 13 patients was 68.54±11.86 mins.Blocking time of uterine blood vessels with one-time puncture drainage tube was 22.54±8.31 min.Intraoperative bleeding volume was 496.15±161.33 ml.Blood loss within 24 hours was 611.54±160.62 ml,and only one case received Blood transfusion.There were no surgical complications such as bladder and bowel injury in the 13 patients,and no cases received hysterectomy.No Cases suffered from puerperal infection or late postpartum hemorrhage.Postoperative hospitalization time was 4.69±1.18 days.Conclusions:It is a simple,safe,and effective method in treating complete placenta previa combined with placenta increta(placenta implantation score<10 points)by drainage tube binding lower uterine segment followed by uterine spiral stitching,which can control massive bleeding during the operation,reduce the complications of operation and promote the maternity rehabilitation.
作者
瞿琳
殷茵
周欣
QU Lin;YIN Yin;ZHOU Xin(Department of Obstetrics,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing Jiangsu 210029,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2021年第8期609-613,共5页
Journal of Practical Obstetrics and Gynecology
关键词
完全性前置胎盘
胎盘植入
穿刺引流管
螺旋式缝合
手术效果
Complete placenta previa
Placenta increta
Drainage Tube
Stitching techniques
Effect of opera-tion
作者简介
通信作者:周欣,E-mail:zhouxinl01@sina.com。
