既往剖宫产次数对行子宫切除的胎盘植入性疾病患者预后的影响
Effect of previous cesarean section number on prognosis of patients with placental accretion disease undergoing hysterectomy
李雪艳 1王进胜 1梁娟1
作者信息
- 1. 铜川市人民医院妇产科 陕西 铜川 727000
- 折叠
摘要
目的 研究既往剖宫产次数对行子宫切除的胎盘植入性疾病(PAS)患者预后的影响.方法 回顾性收集自2021年3月至2024年1月铜川市人民医院收治的140例PAS患者.以患者既往剖宫产手术次数为依据进行分组,既往剖宫产史次数为0的15例纳入无剖宫产组,既往剖宫产史次数为1次的82例纳入剖宫产1次组,既往剖宫产史次数在2次及以上的43例纳入剖宫产2次以上组.对比3组患者的一般资料与临床结局,单因素与多因素分析对不同剖宫产次数患者的临床预后进行分析.结果 3组患者中高龄产妇、不同孕周、PAS分型比率比较,差异均无统计学意义(P＞0.05);3组患者的孕次、产次、体重指数、前置胎盘比率比较,差异均有统计学意义(P＜0.05).3组患者子宫动脉栓塞、休克、产后出血、出血量超过1 500 mL、进入ICU、输血比率比较,差异均无统计学意义(P＞0.05).经单因素分析,不同次数剖宫产患者与子宫动脉栓塞、休克、产后出血、出血量超过1 500 mL、进入ICU、输血均有明显的影响(P＜0.05).多因素Logistic回归分析中不同剖宫产次数与临床结局均无明显的相关性(P＞0.05).结论 既往剖宫产次数并非行子宫切除的PAS患者预后的独立影响因素,不适合作为判定临床预后的关键性指标.
Abstract
Objective To investigate the effect of the number of previous cesarean sections on the prognosis of patients with placental ac-creta disease(PAS)undergoing hysterectomy.Methods A total of 140 patients with PAS admitted to Tongchuan Peoples Hospital from March 2021 to January 2024 were retrospectively collected.According to the number of previous cesarean section operations,15 patients with a history of 0 cesarean sections as the no cesarean section group,82 patients with a history of 1 cesarean section as the one cesarean section group,and 43 pa-tients with a history of more than 2 cesarean sections as the more than 2 cesarean sections group.The general data and clinical outcome of patients with different cesarean section times were compared,and the clinical prognosis of patients with different cesarean section times was analyzed by un-ivariate and multivariate analysis.Results There were no statistically significant differences in the ratio of elderly parturients,different gestational weeks and PAS classification among the three groups(P＞0.05).There were statistically significant differences in gravidity,parity,body mass index and placenta previa ratio among the three groups(P＜0.05).There were no statistically significant differences in uterine artery emboliza-tion,shock,postpartum hemorrhage,bleeding volume more than 1 500 mL,enttered the ICU and blood transfusion rate among the three groups(P＞0.05).By unifactorial analysis,uterine artery embolism,shock,postpartum hemorrhage,bleeding volume over 1 500 mL,enttered the ICU,blood transfusion were significantly affected by different times of cesarean section(P＜0.05).There was no statistically significant correla-tion between different cesarean section times and clinical outcome in multivariate Logistic regression analysis(P＞0.05).Conclusion The number of previous cesarean sections is not an independent prognostic factor for PAS patients undergoing hysterectomy,and is not suitable as a key indicator for determining clinical prognosis.
关键词
胎盘植入性疾病/子宫切除术/预后/既往剖宫产次数Key words
Placental accreta disease/Hysterectomy/Prognosis/The number of cesarean section引用本文复制引用
出版年
2024
NETL
NSTL
万方数据