前置胎盘围产期孕妇子宫切除术的影响因素分析

摘要

Objective To explore the risk factors of hysterectomy in perinatal pegnant women with placenta previa.Methods A retrospective analysis on clinical data of 500 perinatal women with placenta previa who underwent birth examination and delivery in Ninth People's Hospital of Shenyang City from October 2012 to February 2017 was carried out.Hysterectomy rate in perinatal women with placenta previa was calculated.Differences in age,history of caesarean section,type of placenta previa and level of hemogloin(Hb)were compared between hysterectomy group and non resection group.Risk factors of hysterectomy in perinatal women with placenta previa were analyzed.Results Hysterectomy was performed on 40 cases in 500 perinatal women with placenta previa,and hysterectomy rate was 8.00%.Placenta previa patients aged 35 and above,history of cesarean section,history of abortion,pernicious placenta previa,placenta implantation,twins and Hb lower than 60g/L had high perinatal hysterectomy rate, while tocolysis and C reactive protein(CRP)level had noI remarkable influence on perinatal hysterectomy rate in patients with placenta previa.Age of ≥35 and above,pernicious placenta previa and Hb<60g/L were risk factors of hysterectomy in perinatal women with placenta previa,which OR(95% CI)value was 6.325(1.872-14.082),5.987(3.212-11.758)and 4.885(1.315-8.967),respectively.Conclusion Advanced age,pernicious placenta previa and Hb < 60g/L are risk factors for hysterectomy in perinatal women with placenta previa,so they should be paid close attention to during antenatal examination.%目的 探讨前置胎盘围产期孕妇子宫切除的危险因素.方法 回顾性分析2012年10月至2017年2月在沈阳市第九人民医院接受产检和分娩的500例前置胎盘围产期产妇的临床资料,统计前置胎盘围产期产妇的子宫切除率.比较子宫切除组和未切除组患者年龄、剖宫产史、前置胎盘类型、血红蛋白(Hb)水平等的差异,分析影响前置胎盘孕妇围产期子宫切除的危险因素.结果 500例前置胎盘围产期产妇中40例进行了子宫切除,子宫切除率为8.00%;年龄≥35岁、有剖宫产史、有流产史、凶险型前置胎盘、胎盘植入、双胎和 Hb<60g/L的前置胎盘患者围产期子宫切除率较高,而是否有安胎史和C -反应蛋白(CRP)水平对前置胎盘患者围产期子宫切除率无明显影响;年龄≥35岁、凶险型前置胎盘、Hb<60g/L是前置胎盘围产期孕妇进行子宫切除的危险因素,其 OR(95% CI)分别为6.325(1.872~14.082)、5.987(3.212~11.758)和4.885(1.315~8.967),均 P<0.05.结论 高龄、凶险型前置胎盘、Hb<60g/L是前置胎盘围产期孕妇进行子宫切除的危险因素,提示临床产检中应密切关注.