目的 探讨凶险性前置胎盘伴胎盘植入致围产期子宫切除的临床特点.方法 选择2015年2月至2017年2月在本院产科住院分娩的产妇80例,其中40例凶险性前置胎盘伴胎盘植入患者为观察组,40例普通型前置胎盘患者为对照组.比较两组产妇的产后出血发生率、出血量、子宫切除情况及治疗后出血发生率.结果 两组产妇的基本资料比较差异无显著性(P>0.05).观察组产妇产后出血发生率(75%)明显高于对照组(12.5%),观察组产妇的产后出血量为(1539.8±124.1)ml,明显高于对照组产妇的(458.5±36.2)ml,差异有显著性(t=56.2145,P=0.001).观察组产妇子宫全切除率(32.5%)、次全切除率(67.5%)明显高于对照组(分别为7.5%、15%),差异有显著性(P<0.05).观察组产后出血的发生率与对照组比较差异无显著(P>0.05).结论 凶险性前置胎盘伴胎盘植入产妇产后出血的发生率高,采用子宫切除治疗可有效减少产后出血的发生.%Objective To investigate the clinical effect of perinatal hysterectomy with implantation of pernicious placenta previa. Method 80 cases of maternity hospital delivery from February 2015 to February 2017 were enrolled in this study, including 40 cases of patients with implanted pernicious placenta previa, 40 cases of common type of placenta previa patients were the observation group and the control group. The incidence of postpartum hemorrhage, the amount of bleeding, hysterectomy and the incidence of bleeding after treatment were compared between the two groups. Result There was no significant difference between the two groups in the basic data (P>0.05). The incidence of postpartum hemorrhage of observation group (75%) was significantly higher than that of control group (12.5%); The maternal blood loss of the observation group of maternal postpartum (458.5+36.2)ml was higher than control group,there was statistically significantly (t=56.2145, P<0.01). The total hysterectomy rate and subtotal resection rate of the observation group were significantly higher than that of the control group, the difference was statistically significant (P<0.05). After treatment, the incidence of postpartum hemorrhage in the observation group was not significantly different from that in the control group (P>0.05). Conclusion The incidence of postpartum hemorrhage in implanted pernicious placenta previa is high, and hysterectomy is effective to reduce the occurrence of postpartum hemorrhage.
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