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确定胎盘增殖谱外科管理中的泌尿症并发症的风险因素

Lory Hage¹, Yoann Athiel², Mathilde Barrois²

¹Department of Urology, Cochin Hospital, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France.

World journal of urology

|September 26, 2024

概括

胎盘增生谱 (PAS) 的手术管理可能导致严重的泌尿症并发症,特别是膀和尿道损伤. 胎盘穿和紧急子宫切除术增加了这些严重的手术内伤害的风险.

科学领域:

泌尿和妇科泌尿和妇科
孕产妇和胎儿医学孕产妇和胎儿医学
外科泌尿外科手术泌尿外科

背景情况:

胎盘增生谱 (PAS) 涵盖了异常胎盘侵袭的情况.
通过外科手术治疗PAS,可能会出现显著的手术内和手术后并发症.
在PAS手术中,泌尿器官损伤是一个关键问题.

研究的目的:

在PAS的外科治疗过程中详细说明泌尿学并发症.
为了确定PAS患者泌尿损伤的危险因素.
评估泌尿病损伤对术后结果的影响.

主要方法:

对216名接受手术的PAS患者 (2002-2023) 的回顾性分析.
在手术期间和手术后的泌尿病损伤 (膀/尿道) 的详细描述.
风险因素的单变量和多变量分析;结果的Clavien-Dindo分类.

主要成果:

47名 (21.48%) 患者经历了手术期间膀和/或尿道损伤.
与胎盘形 (6.38%) 相比,胎盘形 (72.34%) 显著增加了泌尿损伤风险.
膀侵袭和紧急子宫切除的胎盘形是尿道损伤的关键风险因素.

结论:

手术PAS管理与大量的泌尿病发病率有关.
泌尿系统并发症显著恶化了手术后的结果 (Clavien-Dindo ≥3).
风险与胎盘入侵深度和子宫切除急迫性有关.

关键词:

异常入侵的胎盘异常入侵的胎盘克拉维恩 - 丁多分类.胎盘增殖的光谱手术并发症手术并发症泌尿病的发病率泌尿病的发病率

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