凶险型前置胎盘并发胎盘植入33例临床治疗探讨

为了分析凶险型前置胎盘并发胎盘植入的临床并发症,探讨其围术期处理,选择首都医科大学附属北京妇产医院2009年1月-2013年12月确诊为凶险型前置胎盘合并胎盘植入的33例病例,研究该疾病的临床并发症和围术期处理.结果显示,凶险型前置胎盘并发胎盘植入发生率为21.15%,所有病例均采用手术终止妊娠,其中子宫切除率为24.24%(8/33).认为凶险型前置胎盘患者应警惕并发胎盘植入,凶险型前置胎盘合并胎盘植入的子宫切除率高,应进行充分的术前准备,术中需要结合多种止血方法控制出血,止血无效者需适时切除子宫.

Clinical analysis on 33 cases of pernicious placenta previa with placenta accreta

T he aim is to study the perioperative management .We analyze the clinical complications of pernicious placenta previa complicated with placenta accrete ,taking totally 33 patients of pernicious placenta previa complicated with placenta accrete ,who had admitted to our hospital from January 2009 to December 2013 ,as the samples ,and summarize the clinical complications of the disease and perioperative management . T he results show that the incidence rate of pernicious placenta previa complicated with placenta accreta was 21 .15% .All patients of pernicious placenta previa complicated with placenta accrete were treated by operation ,and the uterus resection rate was 24 .24% （8/33） . T hus the patients of pernicious placenta previa should alert complicated placenta accrete .T he uterus resection rate increases for cases of pernicious placenta previa complicated with placenta accreta ,so they should be given adequate preoperative preparation ,the intraoperative bleeding should combine a variety of methods to control bleeding ,timely hysterectomy was necessary when the treatment was ineffective .