摘要
目的分析前置胎盘患者合并胎盘植入的危险因素,并探讨子宫动脉上行支结扎对母婴结局的影响。方法选择2013年1月至2015年12月东莞市妇幼保健院收治的前置胎盘患者401例,其中合并胎盘植入98例(观察组),单纯前置胎盘303例(对照组),分析前置胎盘并胎盘植入的危险因素。98例前置胎盘合并胎盘植入患者中,42例患者术中给予子宫动脉上行支结扎干预(子宫动脉上行支结扎组),56例未进行子宫动脉上行支结扎干预(子宫动脉上行支未结扎组),比较2组患者的母婴结局。结果观察组孕次>2、有剖宫产史、有流产史、完全型前置胎盘患者比例显著高于对照组(P<0.05),2组患者的年龄、孕周、既往前置胎盘史、既往胎盘植入史比较差异均无统计学意义(P>0.05)。孕次、剖宫产史、流产史、前置胎盘类型是前置胎盘合并胎盘植入的独立危险因素(P<0.05)。子宫动脉上行支结扎组患者子宫切除率、转入重症监护病房率、出血量、住院时间均显著低于子宫动脉上行支未结扎组(P<0.05),2组患者产褥感染率比较差异无统计学意义(P>0.05)。2组新生儿转入新生儿监护病房率、Apgar评分及体质量比较差异均无统计学意义(P>0.05)。结论孕次、剖宫产史、流产史、前置胎盘类型是前置胎盘合并胎盘植入的独立危险因素。子宫动脉上行支结扎可有效减少前置胎盘合并胎盘植入对母体的危害。
Objective To analyze the risk factors for placenta praevia combined with placenta implantation,and to explore the effect of the ligation of ascending branch of uterine artery on maternal and infant outcomes. Methods A total of 401 patients with placenta previa were selected in Maternal and Child Health Hospital of Dongguan City from January 2013 to December 2015. Among the patients,the placenta implantation occurred in 98 patients（ observation group）,and only placenta praevia occurred in 303 patients（ control group）. The risk factors for placenta praevia combined with placenta implantation were analyzed. Among the 98 cases of placenta praevia combined with placenta implantation,the ascending branch of uterine artery was ligatured in 42 cases（ ligation group）,and the ascending branch of uterine artery was not ligatured in 56 cases（ no ligation group）. The maternal and infant outcomes were compared between the two groups. Results The proportion of patients with gravidity〉2,cesarean section history,abortion history and complete placenta previa in observation group were significantly higher than those in control group（ P〈0. 05）. There was no significant difference in the age,gestational weeks,placenta praevia history and placenta implantation history of patients between the two groups（ P〈0. 05）. The gravidity,cesarean section history,abortion history and the types of placenta praevia were the independent risk factors for placenta praevia combined with placenta implantation（ P〉0. 05）. The hysterectomy rate,transfering to intensive care unit rate,blood loss and hospitalization time in ligation group were significantly lower than those in no ligation group（ P〈0. 05）; but there was significant difference in the puerperal infection rate of patients between the two groups（ P〉0. 05）. There was no significant difference in the rate of transfering to neonatal intensive care unit rate,Apgar score and body mass of neonatus between the two groups（ P〉0. 05）.Conclusion The gravidity,cesarean section history,abortion history and the types of placenta praevia were the independent risk factors for placenta praevia combined with placenta implantation. The ligation of ascending branch of uterine artery can effectively reduce the harm of placenta praevia and placenta implantation to the mothers.
出处
《新乡医学院学报》
CAS
2017年第1期43-46,共4页
Journal of Xinxiang Medical University
基金
东莞市社会科技发展项目(编号:2013108101020)
关键词
前置胎盘
胎盘植入
危险因素
子宫动脉上行支结扎
母婴结局
placenta previa
placenta implantation
risk factor
ligation of ascending branch of uterine artery
maternal and infant outcomes
