摘要
目的研究凶险性前置胎盘患者行剖宫产+子宫下段部分环形切除术+端端吻合术重建子宫的价值。方法选择2018年1月—2020年10月本院48例Ⅱ、Ⅲ型凶险性前置胎盘患者作为研究对象,用随机数表法分为观察组和对照组,其中观察组24例,对照组24例。观察组行剖宫产+子宫下段部分环形切除术+端端吻合术,对照组行剖宫产后给予常规止血治疗。记录并比较两组围术期指标(术中出血量、术后24 h出血量、输血量、手术时间、住院时间),母婴结局(早产、新生儿窒息、子宫切除、转ICU情况)及术后并发症(产褥感染、下肢血栓、泌尿系统损伤、产后大出血、绝经、产后抑郁)发生情况,检测两组治疗前后卵巢功能[抗缪勒管激素(AMH)、促卵泡生成激素(FSH)、促黄体生成素(LH)、雌二醇(E 2)]。结果观察组术中出血量、术后24h出血量、输血量、住院时间均低于对照组,差异有统计学意义(P<0.05);治疗后1个月,观察组AMH、E 2水平比对照组高,FSH、LH水平比对照组低,差异有统计学意义(P<0.05);观察组子宫切除的情况少于对照组,差异有统计学意义(P<0.05);观察组术后并发症总发生率明显低于对照组,差异有统计学意义(P<0.05)。结论凶险性前置胎盘患者行剖宫产+子宫下段部分环形切除术+端端吻合术重建子宫能减少产妇出血量、保留患者子宫、减少术后并发症发生率,具有推广价值。
Objective To study the value of cesarean section,partial circular hysterectomy and end-to-end anastomosis in the reconstruction of uterus in patients with pernicious placenta previa.Methods From January 2018 to October 2020,48 patients with type II and III pernicious placenta previa in our hospital were selected and randomly divided into two groups,with 24 cases in the observation group and 24 cases in the control group.The observation group received cesarean section+partial circular hysterectomy+end-to-end anastomosis,while the control group received routine hemostasis after cesarean section.The perioperative indexes(intraoperative blood loss,postoperative 24 h blood loss,blood transfusion volume,operation time,hospitalization time),maternal and infant outcomes(preterm birth,neonatal asphyxia,hysterectomy,ICU transfer)and postoperative complications(puerperal infection,lower extremity thrombosis,urinary system injury,postpartum hemorrhage,menopause,postpartum depression)were recorded and compared between the two groups,and the ovarian function(AMH,FSH,LH,E2)was detected before and after treatment.Results The intraoperative blood loss,postoperative 24h blood loss,blood transfusion volume and hospital stay in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05);one month after treatment,the levels of AMH and E2 in the observation group were higher than those in the control group,while the levels of FSH and LH in the observation group were lower than those in the control group(P<0.05);the total incidence of postoperative complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Cesarean section,partial annular resection of lower uterine segment and end-to-end anastomosis for uterine reconstruction in patients with pernicious placenta previa can reduce the amount of maternal bleeding,preserve the patient’s uterus,and reduce the incidence of postoperative complications,which is worthy of promo
作者
朱瑞珍
项金晶
苏汝娴
陈劲
董阳阳
ZHU Ruizhen;XIANG Jinjing;SU Ruxian;CHEN Jin;DONG Yangyang(Yangjiang people’s Hospital,Yangjiang 529500,China;不详)
出处
《现代医院》
2021年第7期1116-1118,共3页
Modern Hospitals
基金
广东省医学科研基金项目(20201270)。
关键词
凶险性前置胎盘
剖宫产
子宫下段部分环形切除术
端端吻合术
卵巢功能
Pernicious Placenta Previa
Cesarean Section
Partial Annular Hysterectomy
End-to-end Anastomosis
Ovarian Function
