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[经腹膜侧入路改良剖宫产子宫切除术治疗孕晚期完全性前置胎盘]

[Modified cesarean hysterectomy for placenta previa percreta in the third trimester via peritoneum lateral approach].

作者信息

Liu Qiaoshu, Zhang Jing, Zhang Weishe, Dong Meilian, Wu Xinhua

机构信息

Department of Obstetrics and Gynecology, Xiangya Hospital, Central South University, Changsha, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2013 Jun;38(6):617-22. doi: 10.3969/j.issn.1672-7347.2013.06.011.

Abstract

OBJECTIVE

To investigate the application of modified cesarean hysterectomy for placenta previa percreta in the third trimester via peritoneum lateral approach.

METHODS

Data of 8 patients at 34 weeks or more gestation, who underwent cesarean hysterectomy for placenta previa percreta in Xiangya Hospital, Central South University, between January 2008 and December 2011, were analyzed retrospectively. The patients were divided into a modified cesarean hysterectomy by peritoneum lateral approach group (modified group, n=4) and a conventional cesarean hysterectomy group (conventional group, n=4), according to the principles of the case-control and the operation performed by the same doctor. The incidence of blood loss, the number of transfusions of RBC, and the ocurrnce of complications were compared between the 2 groups.

RESULTS

The blood loss in the modified group and the conventional group was (2280±687) mL and (6150±2023) mL, and the number of transfusions of RBC was (4.5±2.1) U and (11.7±8.9) U, respectively. There was no coagulation disorder and ureteral injury in the modified group whereas there were 2 disorders and 1 injury in the conventional group. Two patients with bladder laceration were observed in the 2 groups.

CONCLUSION

Large amounts of bleeding will be onset in the placenta previa percreta. Modified cesarean hysterectomy for placenta previa percreta can reduce the blood loss and the incidence of related complications in the operation.

摘要

目的

探讨改良经腹膜侧入路剖宫产子宫切除术在孕晚期完全性前置胎盘中的应用。

方法

回顾性分析2008年1月至2011年12月在中南大学湘雅医院接受剖宫产子宫切除术治疗完全性前置胎盘且孕周≥34周的8例患者资料。根据病例对照原则且由同一医生手术,将患者分为改良经腹膜侧入路剖宫产子宫切除术组(改良组,n = 4)和传统剖宫产子宫切除术组(传统组,n = 4)。比较两组术中出血量、红细胞输注量及并发症发生情况。

结果

改良组和传统组术中出血量分别为(2280±687)ml和(6150±2023)ml,红细胞输注量分别为(4.5±2.1)U和(11.7±8.9)U。改良组无凝血功能障碍及输尿管损伤发生,传统组有2例凝血功能障碍及1例输尿管损伤。两组均观察到2例膀胱撕裂患者。

结论

完全性前置胎盘手术中会出现大量出血。改良剖宫产子宫切除术治疗完全性前置胎盘可减少术中出血量及相关并发症的发生。

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