摘要
目的探讨多学科协作(MDT)诊疗模式在改善前置胎盘伴胎盘植入母儿结局中的临床价值。方法回顾性分析2017年1月至2022年12月于江西省妇幼保健院分娩的281例前置胎盘伴胎盘植入产妇的临床资料,根据剖宫产术前是否进行MDT诊疗进行分组,其中MDT组152例,非MDT组129例。比较两组的剖宫产术前胎盘植入部位诊断准确性、术前预处理情况及母儿妊娠结局。结果MDT组术前胎盘植入部位的诊断符合率高于非MDT组,MDT组的腹主动脉球囊阻断率及输尿管置管率均高于非MDT组,且MDT组的术中出血量、出血>2000 ml率、输红细胞量及子宫切除率均低于非MDT组,差异有统计学意义(P<0.05)。结论MDT诊疗模式可以提高前置胎盘伴胎盘植入部位的术前诊断准确性,利于术者制定个体化的精准治疗方案,能有效减少胎盘植入患者术中出血量、输血量,降低子宫切除率,在改善母儿妊娠结局中具有一定临床价值。
Objective To explore the clinical value of multidisciplinary team(MDT)diagnosis and treatment mode in improving the maternal and fetal outcomes of placental previa with placental implantation.Methods A retrospective analysis was conducted on the clinical data of 281 patients with placenta previa and placental implantation who delivered at Jiangxi Maternal and Child Health Hospital from January 2017 to December 2022.According to whether MDT was performed before cesarean section,there were 152 cases in the MDT group and 129 cases in the non-MDT group.The diagnostic accuracy of placenta accreta site before cesarean section,preoperative pretreatment,and maternal and fetal pregnancy outcomes were compared between the two groups.Results The preoperative diagnosis coincidence rate of placenta implantation site in the MDT group was higher than that in the non-MDT group,the abdominal aortic balloon occlusion rate and ureteral catheterization rate in the MDT group were higher than those in the non-MDT group,and the intraoperative blood loss,bleeding>2000 ml rate,red blood cell transfusion volume and hysterectomy rate in the MDT group were lower than those in the non-MDT group,and the differences were statistically significant(P<0.05).Conclusion MDT diagnosis and treatment mode can improve the accuracy of preoperative diagnosis of placenta previa with placenta accreta,help surgeons to develop individualized and precise treatment plans,and effectively reduce the amount of intraoperative blood loss,blood transfusion and reduced hysterectomy rate in patients with placenta accreta,which has certain clinical value in improving the pregnancy outcome of mother and child.
作者
万虹
辛思明
袁燕
曾晓明
刘凌芝
WAN Hong;XIN Siming;YUAN Yan;ZENG Xiaoming;LIU Lingzhi(Department of Obsterics,Jiangxi Maternal and Child Health Hospital,Jiangxi Province,Nanchang 330006,China)
出处
《中国当代医药》
CAS
2024年第12期95-99,共5页
China Modern Medicine
基金
江西省卫生健康委科技计划项目(202110090)。
关键词
多学科协作诊疗模式
前置胎盘伴胎盘植入
诊断准确性
母儿结局
临床价值
Multidisciplinary team diagnosis and treatment mode
Placental previa with placental implantation
Diagnostic compliance rate
Maternal and fetal outcomes
Clinical value
