多学科协作治疗模式在凶险性前置胎盘中的临床应用研究

目的 探讨多学科协作治疗模式(multi-disciplinary team,MDT)治疗凶险性前置胎盘的临床疗效。方法 选取成都市第五人民医院2014年1月至2015年6月收治的未行MDT的凶险性前置胎盘44例作为对照组,2015年7月至2016年9月收治的实施MDT的凶险性前置胎盘59例作为研究组,比较2组的产后出血率、产后出血量、输血率、输同型红细胞悬液血量、输同型新鲜冰冻血浆量、子宫切除情况。结果 研究组较对照组产后出血率低(研究组10%,对照组25%)、产后出血量少(研究组821.19±278.7ml,对照组1435.23±648.9 ml)、输血率低(研究组2%,对照组输血率7%)、输同型红细胞悬液血量少(研究组0.136±0.7U,对照组3.659±3.3U)、输同型新鲜冰冻血浆量少(研究组0ml,对照组188.636±422.735ml),差异均有统计学意义(P<0.05)。子宫切除率研究组较低(研究组2%,对照组6%),但两组差异无统计学意义(P >0.05)。结论 采用多学科协作治疗模式治疗凶险性前置胎盘,能明显减少患者产后出血率及产后出血量,减少患者的输血量,取得较好的临床疗效。

Clinical application of multi-disciplinary treatment in dangerous placenta previa

Objective To explore the clinical efficacy of multi-disciplinary treatment (MDT) in the treatment of dangerous placenta previa. Methods 44 cases of non-MDT dangerous placenta previa delivered from January 2014 to June 2015 at Chengdu Fifth People's Hospital were selected as control group,and 59 patients with risky placenta previa underwent MDT delivered from July 2015 to September 2016 were selected as a study group.The postpartum hemorrhage rate,postpartum hemorrhage,transfusion rate,transfusion rate,transfusion rate,fresh frozen plasma volume and hysterectomy were compared in the two groups. Results Compared with the control group,there was a lower postpartum hemorrhage rate (10% in the study group and 25% in the control group),less postpartum hemorrhage (821.19±278.7 ml in study group,1455.23±648.9 ml in control group),lower blood transfusion rate (the team 2%,control blood transfusion rate 7%),fewer homo erythrocyte suspensions (0.136±0.7U for study group,3.659±3.3U for control group) and less fresh frozen plasma (study group,0ml,control group,188.636±422.735ml) in the study group,and the differences were statistically significant (P<0.05).Uterus resection rate was lower in the study group (study group 2%,control group 6%),but the difference had no statistical significance (P>0.05). Conclusion Using multidisciplinary collaborative therapy to treat dangerous placenta previa can significantly reduce the rate and the amount of postpartum hemorrhage,reduce blood transfusion,and achieve better clinical outcomes.