嵌合杂交手术系统在凶险性前置胎盘中的疗效评价

目的 评估嵌合杂交手术系统在凶险性前置胎盘管理中的有效性及安全性.方法 选择2000年6月至2015年12月期间在西安交通大学第一附属医院治疗的65例凶险性前置胎盘患者,分为嵌合组及对照组,嵌合组包括36例采用杂交嵌合系统进行治疗的凶险性前置胎盘患者,对照组包括29例采用常规手术治疗的凶险性前置胎盘患者.分别评估两组患者术中失血量、血制品输注量和围手术期并发症以及DIC发生率、ICU转科率和新生儿结局与术后月经量的改变.结果 嵌合组术中失血量显著少于对照组(615.50±357.14)mL vs(2120.83±1671.55)mL],嵌合组术中红细胞输注量显著少于对照组(438.52±326.33)mL vs(821.66±441.41)mL];两组患者在术后发热发生率(36.1%vs 37.9%)、下肢疼痛发生率(22.2%vs 20.6%)、下肢深静脉血栓发生率(8.3%vs 10.3%)、术后月经恢复时间(112±11)天vs(106±13)天]与经量恢复正常比例(83.3%vs 87.5%)、潮热盗汗发生率(6.8%vs 6.3%)、距离术后第一次性生活开始时间间隔(102±25)天vs(98±31)天]之间未发现存在差异(P>0.05).结论 嵌合杂交系统与传统剖宫产手术比较,能有效降低凶险性前置胎盘患者术中、术后发生率,且不增加母婴不良预后结局的发生.

Therapeutic effect of hybrid system in pernicious placenta previa

Objective To evaluate the efficacy and safety of hybrid system in management of pernicious placenta previa .Methods Between June 2000 and December 2015, 65 women with pernicious placenta previa treated in the First Affiliated Hospital of Xi ' an Jiaotong University were selected and divided into hybrid group and control group .The hybrid groups included 36 cases treated with hybrid system , while the control group included 29 cases treated with routine operation .The amount of blood loss during operation , blood products transfusion, perioperative complications, DIC incidence, ICU transfer incidence, perinatal outcome, and menstruation change after operation were evaluated respectively .Results The amount of blood loss during operation was significantly less in the hybrid group than that in the control group (615.50 ±357.14mL vs 2120.83 ±1671.55mL), and red blood cell transfusion for the hybrid group was obviously less than that for the control group (438.52 ±326.33mL vs 821.66 ±441.41mL).Two groups were not significantly different in incidence of postoperative fever (36.1%vs 37.9%), lower limbs pain (22.2%vs 20.6%), thrombosis (8.3%vs 10.3%), menstruation recover after operation (112 ±11days vs 106 ±13days, proportion of volume recover to normal (83.3%vs 87.5%), hot flashes and night sweats (6.8%vs 6.3%), and interval from first sexual intercourse to operation (102 ±25days vs 98 ±31days) ( all P>0.05).Conclusion Compared with conventional cesearan section , hybrid system can effectively reduce the incidence of pernicious placenta previa during operation and after operation , and adverse maternal and neonatal prognosis will not increase .