凶险型前置胎盘合并切口植入18例临床分析

【目的】探讨产科凶险型前置胎盘合并切口植入的止血技术及子宫切除时机与指征。【方法】回顾性分析2007年7月至2011年7月本院产科收治的凶险性前置胎盘并切口部位植入直径5cm范围以上18例患者的临床资料。【结果】18例病例中7例行子宫切除，11例采用产科改良B-Lynch缝合＋宫腔填塞止血成功保留子宫。【结论】凶险型前置胎盘并切口部位植入直径5cm范围以上者手术止血多需要结合多种方法；改良B-Lynch缝合＋官腔填塞能成功用于其术中的止血；适时手术切除子宫可降低并发症的发生。

Clinical Analysis of 18 Cases of Hazardous Placenta Previa Complicated by Incision Implantation

[Objective] To explore the hemostasis, the timing and indications of hysterectomy of hazardous placenta previa complicated by incision implantatioru [Methods]Clinical data of 18 patients with hazardous placenta previa compli- cated by incision implantation with more than 5cm admitted to our hospital from July 2007 to July 2011 were analyzed ret- rospectively. [Results] Of the 18 patients, 7 patients underwent hysterectomy and 11 patients successfully reserved the u- terus by B-Lynch suture and intrauterine hemostasis with packs. [Conclusion] Some methods should be combined for sur- gical hemostasis of patients with hazardous placenta previa complicated by incision implantation with more than 5cm. Modified B-Lynch suture and intrauterine hemostasis with packs can stop bleeding during the operation successfully. Timely surgical removal of the uterus can reduce the incidence of complications.