[1]李万珍,卢晓红,吴晓兰*.凶险性前置胎盘多学科协作诊疗模式临床研究[J].中国计划生育和妇产科,2018,(12):46-49.
 LI Wan-zhen,LU Xiao-hong,WU Xiao-lan*.Clinical study of multidisciplinary collaborative diagnosis and treatment mode of pernicious placenta previa[J].Chinese Journal of Family Planning & Gynecotokology,2018,(12):46-49.
点击复制

凶险性前置胎盘多学科协作诊疗模式临床研究
分享到:

《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2018年12期
页码:
46-49
栏目:
论著与临床
出版日期:
2018-12-25

文章信息/Info

Title:
Clinical study of multidisciplinary collaborative diagnosis and treatment mode of pernicious placenta previa
作者:
李万珍卢晓红吴晓兰*
成都市第五人民医院妇产科
Author(s):
LI Wan-zhenLU Xiao-hongWU Xiao-lan*
Department of Gynaecology and Obstetrics,Chengdu Fifth People’s Hospital,Chengdu Sichuan 611130,P.R.China
关键词:
凶险性前置胎盘多学科协作诊疗模式母婴结局
Keywords:
pernicious placenta previamultidisciplinary collaborative diagnosis and treatment modematernal and neonatal outcomes
分类号:
R 714
摘要:
目的探讨凶险性前置胎盘(pernicious placenta previa,PPP)多学科协作诊疗模式的临床特点。方法以2012年5月至2016年10月成都市第五人民医院收治的PPP患者86例为研究对象,根据随机数字表法分为对照组与观察组各43例。对照组予以专科诊疗模式,观察组采用多学科协作诊疗模式,比较两组妊娠期间并发症、手术结果,并记录两组母婴结局、比较产妇术后并发症发生情况。结果妊娠期间,对照组并发妊娠期糖尿病、子痫、贫血、体质量指数超标等并发症总发生率721 %,显著高于观察组163 %(P<005);两组均无死亡病例,但对照组术中出血量、输血量、子宫切除率均明显高于观察组(P<005);术后对照组累计大出血发生率明显高于观察组,终止妊娠孕周明显低于观察组(P<005);两组均无新生儿死亡,但对照组呼吸窘迫、低体重等发生率明显高于观察组,Apgar评分明显低于观察组(P<005);术后对照组并发症总发生率256 %,明显高于观察组93 %(P<005)。结论PPP临床治疗中采用多学科协作诊疗模式优势明显,可显著降低妊娠期并发症风险,有效减少患者术中术后出血量,降低新生儿不良事件发生率,有助于患者术后恢复。
Abstract:
ObjectiveTo explore the clinical characteristics of multidisciplinary collaborative diagnosis and treatment mode of pernicious placenta previa(PPP). Methods86 cases of patients with PPP in Chengdu Fifth People’s Hospital were selected for the study and divided into the control group and the observation group according to the random number table method, with 43 cases in each group. The control group was given the diagnosis and treatment mode of specialist treatment and the observation group was given multidisciplinary collaborative diagnosis and treatment mode. The postoperative complications and surgical results in the pregnancy duration were observed between the two groups, and the maternal and neonatal outcomes of the two groups were recorded and the postoperative complications were compared between the two groups. ResultsThe overall incidence rate of combined diabetes mellitus,eclampsia, anemia,BMI and termination of pregnancy was 721 % in the control group, which was significantly higher than that in the observation group with 163 %(P<005). And there was no death case in the two groups, but the intraoperative blood loss amount, blood transfusion volume, hysterectomy rates were significantly higher in the control group than those in the observation group(P<005).The incidence rates of accumulative massive hemorrhage and interventional pulmonary embolism were significantly higher in the control group than those in the observation group, and the gestational age of termination of pregnancy was lower than that of the observation group(P<005). There was no death case in the neonate, and the incidence rate of respiratory distress, low body weight and pneumonia in the control group was significantly higher while the Apgar score was significantly lower than that in the observation group(P<005). The total incidence rate postoperative of complication was 256 % in the control group, which was significantly higher than that in the observation group with 93 % (P<005). ConclusionThe multidisciplinary collaborative diagnosis and treatment mode has significant advantages in the treatment of PPP, can significantly reduce the risk of gestational complications and the postoperative blood loss amount and the incidence rate of neonatal adverse events, which can be helpful for the postoperative recovery.

参考文献/References:

[1]鞠春玲,刘小玲.凶险性前置胎盘的临床治疗分析 [J].临床医学研究与实践,2016,1 (16):48. [2]王利民,罗丹,周辉,等.动脉序贯介入治疗对凶险型前置胎盘的疗效评价 [J].现代妇产科进展,2015,24 (11):823-827. [3]蒋瑜,杨太珠,罗红,等.超声与MRI产前诊断凶险性前置胎盘的临床意义 [J]. 中国超声医学杂志,2016,32 (4):349-351. [4]孙屹立.MRI鉴别前置胎盘不同分型及胎盘植入的敏感性观察 [J].中国CT和MRI杂志,2017,15 (2):70-72. [5]王慧,江华,周晓蓉.超声与MRI产前诊断凶险性前置胎盘的临床意义探讨 [J].临床医学研究与实践,2016,1 (13):129-130. [6]王敏.凶险型前置胎盘围生期处理要点分析 [J].中国基层医药,2015,22 (14):2151-2153. [7]张英,刘晓军,杨媛媛,等. 多学科联合治疗凶险型前置胎盘临床体会 [J].安徽医学,2016,37 (3):289-291. [8]何辅成,李锋,李文娟,等.多学科协作诊疗模式对促进医院学科建设的探讨 [J]. 中国医院,2016,20 (7):12-13. [9]吴金术, 陈晚平. 杂交外科在腹部外科的临床应用 [J].湖南师范大学学报(医学版),2012,9 (4):40-41. [10]牛丽娜,李晓琴,马萍.卡前列素氨丁三醇注射液联合低位 B-Lynch缝合术治疗难治性前置胎盘产后出血的临床疗效及安全性评价 [J].中国基层医药,2016,23 (20):3087-3090. [11]曹冬华.凶险型前置胎盘临床特点及治疗分析(附41例报告) [J].山东医药,2014,54 (18):46-48.

相似文献/References:

[1]林燕.腹主动脉阻断球囊预植入术对凶险性前置胎盘 剖宫产术中止血情况及手术结局的影响[J].中国计划生育和妇产科,2017,(4):38.
 LIN Yan.Effects of pre-implantation of abdominal aortic occlusion balloon on hemostasis and outcome of cesarean section of dangerous placenta previa[J].Chinese Journal of Family Planning & Gynecotokology,2017,(12):38.
[2]倪雪梅*,赖微,朱巧英,等.彩超联合甲胎蛋白在孕晚期预测凶险性前置胎盘合并胎盘植入的应用分析[J].中国计划生育和妇产科,2017,(8):53.
 NI Xue-mei*,LAI Wei,ZHU Qiao-ying,et al.Application of color Doppler ultrasonography combined with alpha fetal protein in prediction of placenta previa complicated with placenta accrete in the third trimester[J].Chinese Journal of Family Planning & Gynecotokology,2017,(12):53.
[3]马俊*,陈葵喜,程珊,等.子宫动脉栓塞术治疗凶险性前置胎盘的应用效果评价[J].中国计划生育和妇产科,2017,(11):43.
 MA Jun*,CHEN Kui-xi,CHENG Shan,et al.Evaluation of the effect of uterine artery embolization in the treatment of dangerous placenta previa[J].Chinese Journal of Family Planning & Gynecotokology,2017,(12):43.
[4]张晨*,李微,王秀梅,等.介入治疗凶险性前置胎盘两种阻断方法的比较[J].中国计划生育和妇产科,2018,(3):65.
 ZHANG Chen*,LI Wei,WANG Xiu-mei,et al.Comparison of two occlusion of interventional treatment methods of pernicious placenta previa[J].Chinese Journal of Family Planning & Gynecotokology,2018,(12):65.
[5]符式新*,张茜,张凯钟,等.磁共振成像对凶险性前置胎盘的诊断价值分析[J].中国计划生育和妇产科,2018,(6):64.
 FU Shi-xin*,ZHANG Qian,ZHANG Kai-zhong,et al.Analysis of diagnostic value of pernicious placenta previa examined by magnetic resonance imaging[J].Chinese Journal of Family Planning & Gynecotokology,2018,(12):64.
[6]曾晓玲,杨慧霞*.环形缝扎联合宫颈球囊压迫成功治疗凶险性前置胎盘伴穿透性胎盘植入侵及宫颈2例[J].中国计划生育和妇产科,2018,(9):95.
[7]林剑霞,程蔚蔚*.凶险性前置胎盘伴胎盘植入的介入治疗研究进展[J].中国计划生育和妇产科,2019,(12):28.
[8]李萍,赵虎,肖雄,等.不同介入阻断术对凶险性前置胎盘患者临床结局的影响[J].中国计划生育和妇产科,2020,(4):41.
 LI Ping,ZHAO Hu,XIAO Xiong,et al.Effects of different interventional block surgery on clinical outcomes of patients with dangerous placenta previa[J].Chinese Journal of Family Planning & Gynecotokology,2020,(12):41.
[9]魏云波,张曙萱*.数字减影血管造影引导下低位腹主动脉球囊阻断术在凶险性前置胎盘治疗中的应用研究[J].中国计划生育和妇产科,2020,(8):41.
 WEI Yunbo,ZHANG Shuxuan*.Application of digital subtraction angiography guided low abdominal aortic balloon occlusion in the treatment of dangerous placenta previa[J].Chinese Journal of Family Planning & Gynecotokology,2020,(12):41.

备注/Memo

备注/Memo:
四川省卫计委课题(项目编号:17PJ247)
更新日期/Last Update: 2018-12-25