钳夹缝扎技术处理前置胎盘局部粘连或植入的应用研究

目的探讨钳夹缝扎技术在前置胎盘局部存在胎盘粘连或植入中应用的安全性和有效性。方法 2009年1月至2013年1月中国医科大学附属第一医院产科共分娩4306例产妇,其中前置胎盘82例(发生率1.90%)。排除凶险性前置胎盘、双胎、边缘性前置胎盘及存在其他能引起出血的疾病的孕妇。共纳入64例前置胎盘行剖宫产术术中发现不同程度的部分胎盘粘连或植入的孕妇为研究对象,术中采用奇偶数分组法分为研究组(采用钳夹缝扎技术处理前置胎盘局部粘连或植入处)和对照组(常规处理胎盘粘连或植入),各为32例。比较分析两组孕妇术中及术后情况。结果两组孕妇在血红蛋白减少[(9.4±6.7)g/L、(24.5±8.6)g/L]、手术时间[(51.2±12.1)min、(76.4±20.4)min]、子宫动脉结扎方面差异均有统计学意义(P0.05)。术后两组均未发生胎盘残留和滋养细胞疾病。结论剖宫产术中采用钳夹缝扎的方法处理前置胎盘粘连或植入的部分安全有效,值得推广。

Application of suturing technique in partial placenta previa adhesions or implanted.

Abstract： Objective To investigate the safety and effectiveness of suturing technique used in partial placenta previa adhesions or implanted. Methods From January 2009 to January 2013 ,there were 4306 cases of delivery in the First Affiliated Hospital of China Medical University, including 82 cases of placenta previa (incidence 1.90%). Excluding dangerous placenta previa, twins, marginal placenta previa and other pregnant women with bleeding disorders,totally 64 pregnant women with placenta previa accepted cesarean section，in which partial placenta adhesions or implanted were found intraoperatively;these women were divided into two groups (parity grouping method respectively). Experimental group： suturing technique was used to deal with placenta adhesions or implanted. Control group：with placenta adhesions or implanted were routinely handled and then hemostatic measures used. Comparatively analyze postoperative condition of pregnant women in two groups. Results There were statistically significant differences in the reduction of Hb,operation time,the proportion of uterine artery ligation.Both groups had no incidence of residual placenta and trophoblastic disease after surgery.