目的探讨凶险型前置胎盘的临床危害及围术期处理。方法回顾性分析手术治疗的76例凶险型前置胎盘为观察组,297例普通型前置胎盘为对照组。结果观察组术中出血量、胎盘粘连、胎盘植入、保守性手术(局部缝扎、局部切除、宫腔填塞、子宫动脉结扎等)、产后出血、输血发生率、子宫切除均多于对照组,差异有统计学意义(P<0.05)。结论①为减少凶险型前置胎盘的临床危害,应加强围术期管理;②子宫的保守性手术及子宫切除治疗均很重要;③减少凶险型前置胎盘的发生,关键是掌握好剖宫产指征、降低剖宫产率。

【Objective】To explore the clinical harm of pernicious placenta previa and perioperative management.【Methods】 We retrospectively analyzed surgical treatment of 76 case of pernicious placenta previa as observation group,297 cases of placenta previa common type as control group.【Resluts】Statistical data of observation group, such as, operative bleeding, placenta accreta, placenta accrete, conservative surgery (partial ligation, local excision, uterine tamponade, uterine artery ligation), postpartum hemorrhage, transfusion incidence of hysterectomy are bigger than the control group , the difference was statistically significant (P<0.05).【Conclusions】① In order to reduce pernicious placenta previa clinical harm, the perioperative management should be strengthen; ② The uterus conservative surgery and hysterectomy treatment are all important; ③ The key to reduce the occurrence of pernicious placenta previa is mastering cesarean testify well and reduce the cesarean section rate.