CAJ | 학술논문

目的：探讨凶险型前置胎盘的诊疗规范及手术方法，减少产后出血、副损伤，降低子宫切除率。方法回顾分析2011年1月至2014年1月在我院就诊的28例凶险型前置胎盘患者的发病原因、治疗方法及预后状况。结果28例孕妇中曾一次剖宫产21例，两次剖宫产3例，三次剖宫产1例，子宫肌瘤挖除术后1例，多次人工流产后2例。28例患者均以剖宫产终止妊娠，发生产后出血28例，子宫切除7例。其中择期手术23例，子宫切除4例；急诊手术5例，子宫切除3例，膀胱损伤2例。结论重视对凶险型前置胎盘的早诊断、早干预；规范围产期处理，术前充分评估，术中正确及时处理，是减少产后出血及副损伤，降低子宫切除率及母儿死亡率的关键。
목적：탐토흉험형전치태반적진료규범급수술방법，감소산후출혈、부손상，강저자궁절제솔。방법회고분석2011년1월지2014년1월재아원취진적28례흉험형전치태반환자적발병원인、치료방법급예후상황。결과28례잉부중증일차부궁산21례，량차부궁산3례，삼차부궁산1례，자궁기류알제술후1례，다차인공유산후2례。28례환자균이부궁산종지임신，발생산후출혈28례，자궁절제7례。기중택기수술23례，자궁절제4례；급진수술5례，자궁절제3례，방광손상2례。결론중시대흉험형전치태반적조진단、조간예；규범위산기처리，술전충분평고，술중정학급시처리，시감소산후출혈급부손상，강저자궁절제솔급모인사망솔적관건。
Objective To investigate the diagnostic standard and surgical methods of dangerous type of pla-centa previa, and reduce postpartum hemorrhage, side effect, and hysterectomy rates. Methods The etiology, treat-ment and prognosis of 28 patients with dangerous type of placenta previa from January 2011 to January 2014 in our hospital were retrospectively analyzed. Results In those 28 cases, there were 21 cases with one previous cesarean section, 3 cases with two previous cesarean section, one case with three times cesarean section, one case with uterine myomectomy surgery, and two cases with repeated abortions. The pregnancy of those 28 patients were terminated by cesarean, in all of which postpartum hemorrhage occurred, and in seven cases of which hysterectomy were performed. There were 23 cases performed elective surgery, among which there were four cases with hysterectomy. There were five cases underwent emergency surgery, among which hysterectomy occurred in three cases, and bladder injury oc-curred in 2 cases. Conclusion Paying attention to early diagnosis and intervention of dangerous type of placenta pre-via, standardizing the perinatal treatment, performing adequate preoperative assessment and proper and timely intraop-erative treatment are important to reduce postpartum bleeding, side injury, and mortality rate of child and mother.