摘要
目的 探讨术中超声引导在前壁前置胎盘剖宫产术切口选择过程中的应用价值。方法 收集2014年1月至2017年1月南宁市第二人民医院产科经腹部超声诊断为前壁前置胎盘行剖宫产术者100例的病历资料，按照术中是否有超声引导分为超声组和对照组，各50例。超声引导组除常规术前经腹部超声外，采取术中超声引导下切开子宫娩出胎儿；对照组仅术前经腹部超声检查胎盘位置，术中根据经验选择切口娩出胎儿。观察2组胎儿娩出前的出血量、胎儿娩出后术中出血量、新生儿Apgar评分、并发症及术后感染等情况。结果 超声组胎儿娩出前出血量、胎儿娩出后术中出血量均明显低于对照组，差异有统计学意义［（13±5）ml比（144±11）ml、（572±97）ml比（839±128）ml］（P＜0.05）。2组新生儿贫血和窒息发生率比较，差异无统计学意义（P＞0.05）。2组均无伤口感染发生。结论 剖宫产术中超声引导可准确定位前壁前置胎盘的位置，指导手术切口的选择，可降低产妇出血风险，应用安全。
Objective To explore the application value of intraoperative ultrasonic location in cesarean section for anterior placenta previa. Methods Totally 100 pregnant women with anterior placenta previa who had cesarean section from January 2014 to January 2017 in Nanning Second People′s Hospital were retrospectively analyzed. The ultrasound group （50 cases） had routine preoperative abdominal ultrasonography and intraoperative ultrasonic guiding for choice of incision position during operation. The control group （50 cases） had routine abdominal ultrasonography before operation; the incision position was chosen based on surgeons′ experience. Blood loss, neonatus Apgar score, complications and postoperative infection were analyzed. Results Blood loss before and after delivery during operation in ultrasound group were significantly less than those in control group[（13±5）ml vs（144±11）ml,（572±97）ml vs（839±128）ml]（P〈0.05）. Incidences of neonatal anemia and asphyxia had no significant differences between groups（P〉0.05）. No wound infection occurred in both groups. Conclusion Intraoperative ultrasonography helps accurate positioning of cesarean incision for anterior placenta previa and reduces the risk of maternal hemorrhage.
出处
《中国医药》
2017年第8期1251-1254,共4页
China Medicine
基金
广西壮族自治区卫生和计划生育委员会自筹经费科研课题（Z2015199）
关键词
剖宫产术
前置胎盘
术中超声
Cesarean section
Placenta previa
Intraoperative ultrasonography
