中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2011年
23期
18-20
,共3页
郑云英%汪燕%张建果%王玲
鄭雲英%汪燕%張建果%王玲
정운영%왕연%장건과%왕령
凶险型前置胎盘%穿透性胎盘植入%手术
兇險型前置胎盤%穿透性胎盤植入%手術
흉험형전치태반%천투성태반식입%수술
Pernicious placenta previa%Placenta percreta%Operation
目的 探讨凶险型前置胎盘并发穿透性胎盘植入的治疗及手术方法,提高母儿救治水平.方法 回顾性分析我院近2年收治的凶险型前置胎盘并发穿透性胎盘植入的3例患者的临床资料.结果 近2年在我院住院分娩孕妇共5002例,凶险型前置胎盘并发穿透性胎盘植入3例,其中1例有1次剖宫产史,1次流产史;1例有2次剖宫产史,2次流产史;1例有1次顺产史,1次剖宫产史,1次流产史.其中1例术中诊断,2例术前彩超检查诊断,3例术后病理确诊胎盘植入.3例终止妊娠的孕周分别为34+5、32+5、34+5周;1例行子宫下段横切口剖宫产术+全子宫切除术,1例行子宫体部纵切口剖宫产术+次全子宫切除术,1例行子宫中段剖宫产术+腹主动脉压迫+子宫动脉结扎术.结论 凶险型前置胎盘终止妊娠的孕周可提前至32 ～34周;术前应充分准备,并制定手术预案;在胎盘娩出前可行腹主动脉压迫及子宫动脉结扎减少出血量,保留子宫.
目的 探討兇險型前置胎盤併髮穿透性胎盤植入的治療及手術方法,提高母兒救治水平.方法 迴顧性分析我院近2年收治的兇險型前置胎盤併髮穿透性胎盤植入的3例患者的臨床資料.結果 近2年在我院住院分娩孕婦共5002例,兇險型前置胎盤併髮穿透性胎盤植入3例,其中1例有1次剖宮產史,1次流產史;1例有2次剖宮產史,2次流產史;1例有1次順產史,1次剖宮產史,1次流產史.其中1例術中診斷,2例術前綵超檢查診斷,3例術後病理確診胎盤植入.3例終止妊娠的孕週分彆為34+5、32+5、34+5週;1例行子宮下段橫切口剖宮產術+全子宮切除術,1例行子宮體部縱切口剖宮產術+次全子宮切除術,1例行子宮中段剖宮產術+腹主動脈壓迫+子宮動脈結扎術.結論 兇險型前置胎盤終止妊娠的孕週可提前至32 ～34週;術前應充分準備,併製定手術預案;在胎盤娩齣前可行腹主動脈壓迫及子宮動脈結扎減少齣血量,保留子宮.
목적 탐토흉험형전치태반병발천투성태반식입적치료급수술방법,제고모인구치수평.방법 회고성분석아원근2년수치적흉험형전치태반병발천투성태반식입적3례환자적림상자료.결과 근2년재아원주원분면잉부공5002례,흉험형전치태반병발천투성태반식입3례,기중1례유1차부궁산사,1차유산사;1례유2차부궁산사,2차유산사;1례유1차순산사,1차부궁산사,1차유산사.기중1례술중진단,2례술전채초검사진단,3례술후병리학진태반식입.3례종지임신적잉주분별위34+5、32+5、34+5주;1례행자궁하단횡절구부궁산술+전자궁절제술,1례행자궁체부종절구부궁산술+차전자궁절제술,1례행자궁중단부궁산술+복주동맥압박+자궁동맥결찰술.결론 흉험형전치태반종지임신적잉주가제전지32 ～34주;술전응충분준비,병제정수술예안;재태반면출전가행복주동맥압박급자궁동맥결찰감소출혈량,보류자궁.
Objective To investigate the treatment and surgical appoach of pernicious placenta previa complicated with placenta percreta so as to enhance the prognosis of the pregnancy women and their babies.Methods The clinical datas were reviewed and analyzed of three women with pernicious placenta previa complicated with placenta percreta in our hospital in the past two years.Results A total of 5002 pregnancy women were admitted to deliver in our hospital in past two years.Three cases were suspected with placenta percreta.One of them had history of cesarean section and abortion once respectively ; Another one had history of cesarean section and abortion twice respectively ; The third one had history of spontaneous delivery,cesarean section and abortion once respectively.With B-ultrasound,two of them were suspected with placenta percreta,all of them were in the diagnosis of postoperative pathologic diagnosis.The gestational age of the 3 patients were 34 +5,32 +5,34 +5 weeks respectively.One case had cesarean section and complete hysterectomy,one case had cesarean section and supracervical hysterectomy,one case had cesarean section,abdominal aorta compression and ligation of uterine artery.Conclusions Time of pregnancy termination can be advanced to 32-34 weeks for the women with pernicious placenta previa.If the placenta percreta is suspected at the scar of previous cesarean section,sufficient preparation and surgical plans are needed preoperatively; Abdominal aorta compression and ligation of uterine artery are needed before placenta expulsion.
