摘要
目的探讨经后路子宫切除与传统子宫切除术治疗穿透性胎盘植入的手术并发症和术后情况。方法回顾性分析2010年12月至2014年5月在广州医科大学第三附属医院诊断为穿透性胎盘植入并行围产期经后路子宫切除术患者18例,以及传统子宫切除术治疗穿透性胎盘植入患者30例,比较两组孕产妇的一般情况、手术并发症及术后情况。结果同期确诊胎盘植入420例,其中48例因发生危及生命的产后出血,需要行围产期子宫切除术(11.4%)。两组均无一例产妇死亡。经后路子宫切除术组术中无一例发生膀胱损伤;而传统子宫切除术组发生了2例术中膀胱损伤(6.7%);经子宫后路切除术组手术后输血量及ICU入住天数与传统子宫切除术组相比差异有统计学意义(P<0.05)。结论相对于传统的围产期子宫切除术,经后路子宫切除术在治疗胎盘植入,尤其是浸润至膀胱的穿透性胎盘植入,可能是更好的手术选择。
Objective To introduce an altered hysterectomy for placenta percreta in a tertiary teaching hospital, comparing operative complications and post-operative conditions with those of the traditional approach. Methods Women diagnosed with placenta percreta and admitted to a university hospital between December 2010 and May 2014 were identified. Eighteen cases received altered hysterectomy thile 30 cases wewe performed traditional hysterectomy. Compare their maternal characteristics, operative complications and post-operative conditions. Results Totally 420 women （1.4%） underwent placenta accrete/increta/perereta, among whom 48 （48/480 or 11.4%） women required peripartum hysterectomy for life-threatening postpartum hemorrhage. In the 48 cases, 18 women received the altered approach for hysterectomy and 30 women were treated with the traditional method. No case of maternal death was observed in either group. In the group treated with the altered method, no women experienced bladder injury, while 2 of the 30 women treated with the traditional method had bladder injury. In addition, women treated with the altered hysterectomy experienced less post-operative blood transfusion and shorter ICU stay （P 〈0.05）. Conclusion Compared to the traditional approach, the altered hysterectomy may be a better surgical option for uncontrollable peripartum hemorrhage caused by placenta percreta with invasion into the bladder.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2015年第12期1117-1120,共4页
Chinese Journal of Practical Gynecology and Obstetrics
关键词
胎盘植入
围产期子宫切除术
手术并发症
placenta perereta
peripartum hysterectomy
operative complications
