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目的探讨凶险性前置胎盘的临床诊断及治疗经验。方法回顾性分析29例凶险性前置胎盘患者的临床资料。根据术中发现胎盘植入和非植入分为植入组15例和非植入组14例。观察两组孕妇产前出血情况、前置胎盘类型与胎盘植入关系、剖宫产术中出血量、产后出血情况及术中处理情况。结果植入组和非植入组产前出血发生率相比,差异有统计学意义(P<0.05),植入组边缘性前置胎盘3例,部分性1例,完全性11例,非植入组分别为10例、2例、2例,两组差异有统计学意义(P<0.05)。结论严格掌握好剖宫产的指征,降低剖宫产率是减少凶险性前置胎盘的根本所在,产前及时诊断,术前做好充分准备,可有效改善预后。
Objective To explore the clinical diagnosis and treatment of dangerous placenta previa. Methods The clinical data of 29 patients with dangerous placenta previa were retrospectively analyzed. According to the intraoperative findings, placenta accreta and non-implantation were divided into 15 cases of implantation group and 14 cases of non-implantation group. The incidence of prenatal bleeding, the relationship between placenta previa and placenta accreta, bleeding during cesarean section, postpartum hemorrhage and intraoperative management were observed. Results There was significant difference in the incidence of prenatal hemorrhage between the implanted group and the non-implanted group (P <0.05). There were 3 cases of marginal placenta previa, 1 partial, 11 complete cases There were 10 cases in the implantation group, 2 cases in 2 cases, and the difference was statistically significant (P <0.05). Conclusion Strict control of indications of cesarean section, reduce the rate of cesarean section is to reduce the risk of placenta previa, prenatal diagnosis, preoperative well prepared, can effectively improve the prognosis.