胎盘植入诊治的临床效果分析(1)
摘要：目的 探討胎盘植入的高危发病因素、诊断及治疗。方法 选择2013年1月～2018年12月于天津市第一中心医院经手术确诊的26例胎盘植入患者作为研究对象，收集患者的年龄、孕次产次、前次分娩方式及时间、术前检查方式、术中出血量、止血方式、胎盘植入部位、终止妊娠时间、胎儿Apgar 1 min评分等临床信息进行分析。结果 26例患者中，共22例中央型前置胎盘，20例合并既往剖宫产史;超声多普勒与磁共振诊断胎盘植入的准确性比较，差异无统计学意义(P=0.346);与术前双侧子宫动脉栓塞组相比，双侧髂内动脉球囊预置组的妊娠终止时间延长(P=0.022)，新生儿窒息情况减轻(P=0.000)，出血量无明显增加(P=0.194)。结论 胎盘植入主要发生于中央型前置胎盘患者，既往剖宫产史为其高危因素;超声多普勒诊断胎盘植入的准确率高，可作为胎盘植入的常规诊断方法;术前双侧髂内动脉预置球囊可明显减少术中出血，推迟妊娠终止时间，提高新生儿质量。
关键词：胎盘植入;凶险性前置胎盘;剖宫产史;髂内动脉;球囊
, 百拇医药
中图分类号：R714.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.10.040
文章编号：1006-1959(2019)10-0122-02
Abstract：Objective To investigate the high-risk factors， diagnosis and treatment of placenta accreta.Methods 26 patients with placenta-preserved patients who were diagnosed in the First Central Hospital of Tianjin from January 2013 to December 2018 were selected as subjects. The age， the second trimester， the previous delivery method and time were collected. The clinical information such as pre-examination， intraoperative blood loss， hemostasis， placenta implantation， termination of pregnancy， and fetal Apgar 1 min score were statistically analyzed.Results Of the 26 patients， 22 had a central placenta previa， and 20 had a history of previous cesarean section. The accuracy of ultrasound Doppler and magnetic resonance diagnosis of placenta was not statistically significant (P=0.346); Compared with the preoperative bilateral uterine artery embolization group， the termination time of pregnancy in the bilateral internal iliac artery balloon preset group was prolonged(P=0.022)， and the neonatal asphyxia was reduced (P=0.000)， there was no significant increase in bleeding volume(P=0.194).Conclusion Placental accreta mainly occurs in patients with central placenta previa， and the history of cesarean section is a high risk factor. Ultrasound Doppler diagnosis of placenta is highly accurate and can be used as a routine diagnostic method for placenta implantation. The preset internal balloon of the lateral iliac artery can significantly reduce intraoperative bleeding， delay the termination of pregnancy， and improve the quality of newborns.
Key words：Placenta accreta;Sinister placenta previa;History of cesarean section;Internal iliac artery;Balloon, 百拇医药(刘晶晶 王得玲)
关键词：胎盘植入;凶险性前置胎盘;剖宫产史;髂内动脉;球囊
, 百拇医药
中图分类号：R714.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.10.040
文章编号：1006-1959(2019)10-0122-02
Abstract：Objective To investigate the high-risk factors， diagnosis and treatment of placenta accreta.Methods 26 patients with placenta-preserved patients who were diagnosed in the First Central Hospital of Tianjin from January 2013 to December 2018 were selected as subjects. The age， the second trimester， the previous delivery method and time were collected. The clinical information such as pre-examination， intraoperative blood loss， hemostasis， placenta implantation， termination of pregnancy， and fetal Apgar 1 min score were statistically analyzed.Results Of the 26 patients， 22 had a central placenta previa， and 20 had a history of previous cesarean section. The accuracy of ultrasound Doppler and magnetic resonance diagnosis of placenta was not statistically significant (P=0.346); Compared with the preoperative bilateral uterine artery embolization group， the termination time of pregnancy in the bilateral internal iliac artery balloon preset group was prolonged(P=0.022)， and the neonatal asphyxia was reduced (P=0.000)， there was no significant increase in bleeding volume(P=0.194).Conclusion Placental accreta mainly occurs in patients with central placenta previa， and the history of cesarean section is a high risk factor. Ultrasound Doppler diagnosis of placenta is highly accurate and can be used as a routine diagnostic method for placenta implantation. The preset internal balloon of the lateral iliac artery can significantly reduce intraoperative bleeding， delay the termination of pregnancy， and improve the quality of newborns.
Key words：Placenta accreta;Sinister placenta previa;History of cesarean section;Internal iliac artery;Balloon, 百拇医药(刘晶晶 王得玲)