前置胎盘患者并发产后出血后行围产期子宫切除术临床分析

2016-07-25门娴

中国卫生标准管理 2016年5期

门娴

门娴

【摘要】目的对前置胎盘患者并发产后出血后行围产期子宫切除术进行临床分析。方法选取2014年5月～2015年5月于我院接受前置胎盘患者90例，其中因前置胎盘后行围产期子宫切除术患者45例作为观察组，另外45未行子宫切除术患者作为对照组，观察比较两组患者相关高危因素及术中出血量，并对观察组患者母婴结局进行分析。结果观察组患者各项高危因素均高于对照组，差异有统计学意义（P＜0．05）。同时观察组患者术中出血量较对照组多，差异有统计学意义（P＜0．05）。观察组中25例（55．56%）因失血过多转入ICU后痊愈；5例（11．11%）因胎儿畸形或死于胎中后进行剖宫取胎；42例新生儿中窒息5例，重度窒息3例，转到新生儿科室中15例；2例患儿死亡。结论高龄、经产妇、剖腹产史及流产史均为前置胎盘患者的高危因素，提高医护人员相关风险意识及手术质量对减少术中出血量及改善母婴结局具有重要意义。【关键词】前置胎盘；产后出血；子宫切除术

Objective To analyse the clinical analysis of peripartum hysterectomy of the placenta previa concurrented postpartum hemorrhage． Methods 90 cases of patients with placenta previa were selected at our hospital from the May 2014 to May 2015，45 cases treated by hysterectomy as the treatment group，and another 45 cases without hysterectomy as the control． We observed the relevant high risk factors，intraoperatve blood soss and the mother-infant end of them． Results The relevant high risk factors of the treatment group was higher than the control，there was statistical significance（P ＜0．05）． The intraoperatve blood soss of the treatment group was more than the control，there was statistical significance（P＜0．05）． There were 25 cases（55．56%）that into the ICU caused by excessive bleeding，and then recovery，5 cases（11．11%）was taken from fetal caused by malformation or died of fetus． There were 5 cases of stifle，3 cases of severe asphyxia，15 cases into the neonatal department，and 2 cases were died of the 42 newborns． Conclusion The advanced age，multipara，history of cesarean section and abortion history was the high risk factors of placenta previa，that has significance to improve the risk awarenes and the operation quality for reducing the bleeding of vagina and improve the mother-infant end．

【Key words】 Placenta previa，Postpartum hemorrhage，Hysterectomy

前置胎盘是一种妊娠晚期出现的并发症，常导致围产期的大量出血，从而增加子宫切除手术的难度及风险，直接影响产妇的生命安全［1-3］。本次研究对置胎盘患者并发产后出血后行围产期子宫切除术进行临床分析，信息全面完整，具体如下。