胎盘边缘切口手术对中央型前置胎盘的临床疗效比较

摘要

Objective To observe the clinical effects of placental edge incision on the treatment of central placenta previa .Methods Sixty-four cases of central placenta previa treated in the First Huizhou Maternal and Child Health Hospital were chosen from April 2011 to January 2013.They were randomly divided into two groups on computer: experiment group and control group both with 32 cases.In the experiment group , the cesarean section was conducted in the way of placental edge incision , while in the control group it was in the way of incision of lower uterine segment .Key indexes were compared between two groups , including amount of bleeding during the operation , operation time , recovery of uterus , uterine resection , neonatal asphyxia rate , postoperative complications and adverse reactions .Results In the experiment group , the amount of bleeding during the operation was obviously less than that in the control group (376.45 ±129.65mL vs 734.56 ±156.34mL, t=9.9741,P<0.05),but the operation time was obviously longer (56.31 ±8.92min vs 45.62 ±7.91min, t=5.0862,P<0.05).The neonatal asphyxia rate was obviously less in the experiment group than in the control group (3.13%vs 25.00%,χ2 =4.6545, P<0.05).There was no statistical significance in the recovery of uterus and the uterine resection (P>0.05).After the operation, there were no complications or adverse reactions in both groups .Conclusion In the application of new placental edge incision in central placenta previa operation ,the amount of bleeding during operation is less and neonatal asphyxia rate is lower than the traditional lower uterine segment method .So it is worth widely using in clinicas .%目的：观察胎盘边缘切口用于中央型前置胎盘手术的临床疗效。方法选取2011年4月至2013年1月期间来惠州市第一妇幼保健院进行治疗的中央型前置胎盘产妇64例，应用计算机随机分为实验组和对照组，每组均为32例。实验组患者采用胎盘边缘切口法进行剖宫产手术，而对照组患者采用子宫下段切口法进行剖宫产手术，对比两组患者在手术期的各项重要指标，如：术中出血量、手术时间、子宫恢复情况、子宫切除情况、新生儿窒息率、术后并发症及不良反应。结果实验组患者术中出血量（376．45±129．65）mL显著少于对照组（734．56±156．34）mL，t＝9．9741，P＜0．05，但实验组患者的手术时间（56．31±8．92） min要显著长于对照组（45．62±7．91）min，t＝5．0862，P＜0．05；实验组的新生儿窒息率（3．13％）要显著小于对照组（25．00％），χ2＝4．6545，P＜0．05。两组患者的子宫恢复情况及子宫切除率无显著统计学差异（P＞0．05），术后两组均无并发症及不良反应出现。结论胎盘边缘切口用于中央性前置胎盘手术中，其术中出血量及新生儿窒息率都显著少于传统的子宫下段切口法，值得临床推广。