前置胎盘伴胎盘植入危险因素分析及宫颈子宫下段环形缝合术对母婴结局的影响.docVIP

前因散析及跡形 对局脚向 2018-03-29 10:29:58中国现代医生2018年6期 张力维李靑齐淑琴王胜年钱自强 ［摘耍］鬥的分析前置胎盤伴胎盘祖入的危险因素，并探讨宫颈子宫下段环形缝合术对前置胎盘 伴胎盘植入的母婴结局影响。方法对2013年8月?2017年2月我院收治的364例前置胎盘患者 进行冋顾性分析，其屮前置胎盘伴胎盘植入者75例（观察组），仅单纯为前置胎盘者289例（对 照组），分析前H胎盘伴胎盘祖入的危险因索。75例前H胎盘伴胎盘植入患者屮25例术屮行宫颈 子宫下段环形缝合术（环形组），50例行传统手术（传统组），比较两组患者母婴结局。结果孕 次、流产史、剖宫产史、前置胎盘类型是前置胎盘伴胎盘祖入发生的单危险因素（P0.05）;两组患 者年龄比较差异无统计学意义：多因素Logistic回归分析孕次、流产史、剖宮产史、前置胎盘类型均 是前置胎盘伴胎盘植入发生的独立危险因素（P0.05）。环形组患者术巾出血最、共计输血最、住院 天数、ICU转入率均显著低于传统组（P0.05）；两组患者手术时间、子宫切除率比较，差异无统计 学意义（P0.05） o两组新生儿出生1 min, 5 min Apgar评分比较，差异有统计学意义（P0.05）; 两组新生儿转入新生儿监护病房率、岀生时体重比较，差异无统计学意义（P0.05）。结论孕次、 流产史、剖宮产史、前置胎盘类型是前置胎盘伴胎盘植入的独立危险因素。宫颈子宫下段环形缝合术 可有效减少前置胎盘伴胎盘植入对母婴的危害。 ［关键词］前H胎盘；胎盘祖入；危险因索；宫颈子宫下段环形缝合术 ［ ］R719.8 ［ ］B ［ 1673-9701 （2018） 06-0056-04 ［Abstract］ Objective To analyze the risk factors of placenta accreta combined with placenta previa and to investigate the effect of cervical suture of lower uterine segment on maternal and infant outcomes. Methods A retrospective analysis was performed on 364 cases of placenta previa admitted from Anhui Medical University Affiliated Anqing Municipal Hospital between August 2013 and February 2017. Among them, 75 cases combined with placenta accrete were chosen as observation group, 289 cases only with placenta previa were chosen as control group, analyzed risk factors of placenta previa combined with placenta accreta. Among the total 75 cases of placenta previa combined with placenta accrete, 25 cases were treated with annular suturing of the lower uterine segment of the cervix （annular group） and 50 cases were treated with conventional operation （traditional group） . Maternal and infant outcomes were compared between the two groups. Results The times of gravidity， abortion history, cesarean section record and type of placenta previa were the single risk factors of placenta previa combined with placenta accreta （P0.05） . There was no significant difference between the two groups in age； Multiple-factors Logistic Regression analysis of pregnancy times， abo