[1]霍春霞,谢 玲.早期结扎双侧子宫动脉上行支在凶险性前置胎盘剖宫产术中的应用[J].医学信息,2020,33(16):101-103.[doi:10.3969/j.issn.1006-1959.2020.16.030]
　HUO Chun-xia,XIE Ling.Application of Early Ligation of the Ascending Branches of Bilateral Uterine Arteries in Cesarean Section for Dangerous Placenta Previa[J].Medical Information,2020,33(16):101-103.[doi:10.3969/j.issn.1006-1959.2020.16.030]
点击复制

早期结扎双侧子宫动脉上行支在凶险性前置胎盘剖宫产术中的应用()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年16期
页码:
101-103
栏目:
临床研究
出版日期:
2020-08-15

文章信息/Info

Title:
Application of Early Ligation of the Ascending Branches of Bilateral Uterine Arteries in Cesarean Section for Dangerous Placenta Previa
文章编号:
1006-1959（2020）16-0101-03
作者:
霍春霞; 谢 玲
（青海红十字医院产科，青海 西宁 810000）
Author(s):
HUO Chun-xia; XIE Ling
(Department of Obstetrics,Qinghai Red Cross Hospital,Xining 810000,Qinghai,China)
关键词:
双侧子宫动脉上行支; 早期结扎; 凶险性前置胎盘; 剖宫产术; 子宫切除率
Keywords:
Ascending branches of bilateral uterine arteries; Early ligation; Dangerous placenta previa; Cesarean section; Hysterectomy rate
分类号:
R719.8
DOI:
10.3969/j.issn.1006-1959.2020.16.030
文献标志码:
A
摘要:
目的 探讨早期结扎双侧子宫动脉上行支对凶险性前置胎盘剖宫产术患者的临床疗效。方法 选择我院2017年10月~2019年10月收治的128例凶险性前置胎盘剖宫产术患者，随机分为观察组（n=64）和对照组（n=64）。对照组给予传统剖宫产术，观察组给予早期结扎双侧子宫动脉上行支处理。比较两组手术时间、术中出血量、术后24h出血量、子宫动脉结扎率、Briki球囊填塞率、子宫切除率、术中输血率及卵巢功能指标水平变化。结果 观察组手术时间、术中出血量、术后24h出血量均低于对照组，差异有统计学意义（P＜0.05）；观察组子宫切除率（23.44%）、术中输血率（28.13%）低于对照组的（64.06%）和（70.31%），差异有统计学意义（P＜0.05）；观察组子宫动脉结扎率（100.00%）高于对照组（92.19%），但差异无统计学意义（P＞0.05）；两组Briki球囊填塞率均为100.00%。观察组LH、FSH、E2水平均低于对照组，差异有统计学意义（P＜0.05）。结论 早期结扎双侧子宫动脉上行支在凶险性前置胎盘剖宫产术中效果确切，可有效缩短手术时间，减少出血量，降低子宫切除率及术中输血率，促进卵巢功能恢复 。
Abstract:
Objective To investigate the clinical effect of early ligation of the ascending branches of the bilateral uterine arteries in patients with dangerous placenta previa cesarean section.Methods A total of 128 patients undergoing caesarean section with dangerous placenta previa admitted to our hospital from October 2017 to October 2019 were randomly divided into observation group (n=64) and control group (n=64). The control group was given traditional cesarean section, and the observation group was given early ligation of the ascending branches of the bilateral uterine arteries. The operation time, intraoperative blood loss, 24h postoperative blood loss, uterine artery ligation rate, Briki balloon packing rate, hysterectomy rate, intraoperative blood transfusion rate and ovarian function index levels were compared between the two groups.Results The operation time, intraoperative blood loss, and 24h postoperative blood loss in the observation group were lower than those in the control group,the difference was statistically significant (P＜0.05); the observation group’s hysterectomy rate (23.44%) and intraoperative blood transfusion rate (28.13%) lower than the control group (64.06%) and (70.31%), the difference was statistically significant (P＜0.05); the observation group’s uterine artery ligation rate (100.00%) was higher than the control group (92.19%), but the difference was not statistically significant(P＞0.05); Briki balloon packing rate of both groups was 100.00%. The LH, FSH and E2 levels of the observation group were lower than those of the control group,the difference was statistically significant (P＜0.05).Conclusion Early ligation of the ascending branches of the bilateral uterine arteries is effective in cesarean section for dangerous placenta previa. It can effectively shorten the operation time, reduce blood loss, reduce the rate of hysterectomy and intraoperative blood transfusion, and promote the recovery of ovarian function.

参考文献/References:

[1]上官亚娟,邹余粮.米索前列醇治疗前置胎盘剖宫产术中大出血的效果[J].实用临床医药杂志,2017,8(19):191-193.[2]余琳,胡可佳,杨慧霞,等.2008-2014年凶险性前置胎盘的回顾性临床研究[J].中华妇产科杂志,2016,51(3):169-173.[3]安瑞.剖宫产瘢痕妊娠发病机制及影响因素[J].中国计划生育学杂志,2018,26(7):643-646.[4]杨慧霞.凶险性前置胎盘伴穿透性胎盘植入手术方法的改进与评价[J].中华围产医学杂志,2017,20(9):630-631.[5]马颖,郭咏梅,陈建虹,等.两种不同止血方式对凶险性前置胎盘患者剖宫产术中出血及预后的影响[J].中国妇幼健康研究,2017,28(10):1229-1231.[6]范晓红.双侧子宫动脉上行支结扎术在中央性前置胎盘剖宫产术中大出血止血的效果[J].中国妇幼保健,2017,32(11):2498-2499.[7]黄安茜,谭艳娟,包凌云,等.超声联合磁共振检查对植入型凶险性前置胎盘的诊断价值[J].中华急诊医学杂志,2014,23(5):567-569.[8]Silver RM.Abnormal Placentation: Placenta Previa, Vasa Previa, and Placenta Accreta [J].Obstet Gynecol,2015,126(3):654-668.[9]彭方亮,周晓.凶险性前置胎盘剖宫产术中早期结扎双侧子宫动脉上行支的临床应用[J].重庆医学,2015,44(22):3131-3132.[10]唐建玲.早期结扎双侧子宫动脉上行支在凶险性前置胎盘中的应用[J].中国继续医学教育,2017,9(36):55-57.[11]Jauniaux E,Bhide A.Prenatal ultrasound diagnosis and outcome of placenta previa accreta after cesarean delivery:a systematic review and meta-analysis[J].Am J Obstet Gynecol,2017,217(1):27-36. [12]牟凤萍,屈清华.双侧子宫动脉上行支结扎在中央性前置胎盘剖宫产术中大出血的应用研究[J].中国计划生育和妇产科,2017,9(8):31-34.[13]Clarke-Pearson DL,Geller EJ.Complications of hysterectomy[J].Obstet Gynecol,2013,121(3): 654-673.[14]刘海意,林星光,乌剑利,等.子宫下段多方位螺旋式缝合成形术在凶险性前置胎盘手术中的应用[J].中华妇产科杂志,2016,51(10):754-758.[15]肖卫芬,韩秋峪.双侧髂内动脉球囊放置封堵术在凶险型前置胎盘终止妊娠中的应用价值[J].中国妇幼保健,2016,31(21):4568-4570.

更新日期/Last Update: 1900-01-01