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目的:探讨术前充分评估准备、术中多种缝合止血方法综合运用对前置胎盘剖宫分娩患者保留子宫的效果。方法:选择前置胎盘剖宫产分娩患者144例,回顾性分析术前评估、术前准备、术中有效的缝合止血方法对前置胎盘剖宫产分娩产妇子宫结局的改善。结果:12009年1月~2013年12月吉林大学第一医院收治的前置胎盘剖宫产分娩患者数量呈逐年上升趋势。22011年之后该院对前置胎盘患者进行术前评估改进和术中多种缝合止血方法综合运用,剖宫产术中子宫切除及产后出血的比率较2011年以前有所下降。3有充分术前准备的择期手术组剖宫产术中子宫切除率和产后出血发生率明显低于急诊手术组,明显改善了产妇结局。结论:充分的术前准备及评估、术中完善的抢救流程、积极有效的缝合止血措施,对降低子宫切除率和减少产后出血有重要意义。
Objective: To explore the preoperative assessment of adequate preparation, a variety of intraoperative suture hemostasis method integrated use of the placenta previa cesarean delivery in patients with retained uterine effect. Methods: A total of 144 patients with cesarean delivery in placenta previa were retrospectively analyzed. Preoperative evaluation, preoperative preparation and effective method of suture and hemostasis during operation were used to improve the outcome of uterine maternal uterine cesarean section. Results: From January 12009 to December 2013, the number of patients with cesarean delivery in front placenta admitted to the First Hospital of Jilin University showed an increasing trend year by year. 22011 after the hospital on the placenta previa assessment of patients with preoperative improvement and a variety of suture hemostasis method of comprehensive utilization of cesarean section in the proportion of hysterectomy and postpartum hemorrhage than before 2011 decreased. In the elective surgery group with adequate preoperative preparation, the rate of hysterectomy and postpartum hemorrhage in cesarean section was significantly lower than that in emergency surgery group, which significantly improved the maternal outcome. CONCLUSION: Adequate preoperative preparation and evaluation, intraoperative perfect rescue procedure and active and effective suture hemostasis measures are important for reducing hysterectomy rate and reducing postpartum hemorrhage.