CN109830297A - A kind for the treatment of method and device of Placenta acrreta patient - Google Patents
A kind for the treatment of method and device of Placenta acrreta patient Download PDFInfo
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- CN109830297A CN109830297A CN201910051218.2A CN201910051218A CN109830297A CN 109830297 A CN109830297 A CN 109830297A CN 201910051218 A CN201910051218 A CN 201910051218A CN 109830297 A CN109830297 A CN 109830297A
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Abstract
The invention discloses the treatment methods and device of a kind of Placenta acrreta patient, are related to medicine technology field, and treatment method includes: to obtain the essential information and Ultrasonic tomography performance information of Placenta acrreta patient;According to the essential information, the Ultrasonic tomography performance information and preset Placenta acrreta degree grade form, the Placenta acrreta degree score value of the Placenta acrreta patient is calculated;The Placenta acrreta patient is treated accordingly according to the Placenta acrreta degree score value.
Description
Technical field
The present invention relates to medicine technology field, in particular to a kind of the treatment method and device of Placenta acrreta patient.
Background technique
MAP (Morbidly adherent placenta, Placenta acrreta) refers to that placental villi invades uterus in various degree
Muscle layer.According to Placenta acrreta mesometrium degree, it is classified as PA (Placenta Accreta, placenta accreta), PI
(Placenta Increta, placenta increta implantation) and PP (Placenta Percreta, placenta percreta implantation).Wherein,
PA refers to placental villi and mesometrium adhesion, has broken through decidua basal layer;PI refers to that placental villi invades mesometrium;PP is
Refer to that placental villi invades uterus holostrome, and reaches placenta percreta and even invade organ near uterus.
China's cesarean delivery rate is high, and with the opening of two tire policies, gestational patients number increases Celiotomy Wean again,
So that the illness rate of Placenta acrreta increases year by year, and Placenta acrreta also has become leads to the urgent uterus of postpartum haemorrhage, perinatal period
The major reason of excision and maternal death and iatrogenic preterm labor in certain region.However currently, related Placenta acrreta diagnoses and that treats faces
Bed research is relatively fewer, lacks evidence-based foundation.Prior art is only merely by determining whether mesometrium and mesometrium
Thickness is to determine whether be Placenta acrreta.However existing document shows have multiple ultrasonic findings to have with Placenta acrreta
Correlation, and mesometrium continuity is only one of them, only by an index, to judge patient, whether there is or not Placenta acrreta mistakes merely
In unilateral, sensibility and specificity be not high.
Summary of the invention
The technical issues of scheme provided according to embodiments of the present invention solves is the standard of the pre-natal diagnosis of Placenta acrreta patient
True property is lower.
The treatment method of the Placenta acrreta patient provided according to embodiments of the present invention a kind of, comprising:
Obtain the essential information and Ultrasonic tomography performance information of Placenta acrreta patient;
According to the essential information, the Ultrasonic tomography performance information and preset Placenta acrreta degree grade form,
Calculate the Placenta acrreta degree score value of the Placenta acrreta patient;
The Placenta acrreta patient is treated accordingly according to the Placenta acrreta degree score value.
Preferably, the essential information includes age, pregnancy number, abortion history, Cesarean esction number and endometrium damage
Hurt history;The Ultrasonic tomography performance information includes placental presentation, low echo, placenta and mesometrium boundary, uterus in placenta
Abnormal blood flow signal after muscle layer echo continuity, perimetrium and bladder boundary, placenta involves bladder sign and involves uterine neck
Sign.
Preferably, it before the essential information for obtaining Placenta acrreta patient and Ultrasonic tomography performance information, also wraps
It includes:
Collect and record the essential information and Ultrasonic tomography performance information of different Placenta acrreta patients;
By the way that different score values is respectively set to the essential information and the Ultrasonic tomography performance information, establish
Placenta acrreta degree grade form comprising the essential information, the Ultrasonic tomography performance information and score value.
Preferably, described according to the essential information, the Ultrasonic tomography performance information and preset Placenta acrreta
Degree grade form, the Placenta acrreta degree score value for calculating the Placenta acrreta patient include:
According to the Ultrasonic tomography performance information of the Placenta acrreta patient and preset Placenta acrreta degree grade form,
Judge that the Placenta acrreta patient is placenta percreta implantation or placenta increta implantation;
If judge that the Placenta acrreta patient is placenta increta implantation, generates and retain Placenta acrreta patient
The reservation in palace cuts off therapeutic scheme, to treat according to the reservation therapeutic scheme to the Placenta acrreta patient;
If judge that the Placenta acrreta patient is placenta percreta implantation, according to the basic of the Placenta acrreta patient
Information, the Ultrasonic tomography performance information and preset Placenta acrreta degree grade form, calculate the Placenta acrreta patient
Placenta acrreta degree score value.
Preferably, the Ultrasonic tomography performance information and preset Placenta acrreta according to the Placenta acrreta patient
Degree grade form judges that the Placenta acrreta patient is placenta percreta implantation or placenta increta implantation includes:
According to the Ultrasonic tomography performance information of the Placenta acrreta patient and preset Placenta acrreta degree grade form,
Calculate the Placenta acrreta patient Ultrasonic tomography performance score value, and by the Ultrasonic tomography performance score value with it is preset
Placenta acrreta score value be compared;
When Ultrasonic tomography performance score value is greater than the preset Placenta acrreta score value, then judge that this is described
Placenta acrreta patient is placenta percreta implantation;
When Ultrasonic tomography performance score value is no more than the preset Placenta acrreta score value, then the institute is judged
Stating Placenta acrreta patient is placenta increta implantation.
Preferably, described that the Placenta acrreta patient is treated accordingly according to the Placenta acrreta degree score value
Include:
The Placenta acrreta degree score value is compared with preset excision uterus score value;
When the Placenta acrreta degree score value is greater than the preset excision uterus score value, then generate described in excision
The excision therapeutic scheme of Placenta acrreta patient uterine, to be carried out according to the excision therapeutic scheme to the Placenta acrreta patient
Treatment;
When the Placenta acrreta degree score value is no more than the preset excision uterus score value, then generates and retain institute
The reservation excision therapeutic scheme of Placenta acrreta patient uterine is stated, to suffer from according to the reservation therapeutic scheme to the Placenta acrreta
Person treats.
Preferably, it is described according to the reservation therapeutic scheme to the Placenta acrreta patient carry out treatment include:
The Placenta acrreta degree score value is compared with preset postpartum haemorrhage score value;
When the Placenta acrreta degree score value is greater than the preset postpartum haemorrhage score value, then it is serious to generate uterus
The therapeutic scheme of postpartum haemorrhage, to control according to the therapeutic scheme of uterus severe postpartum hemorrhage the Placenta acrreta patient
It treats;
When the Placenta acrreta degree score value is no more than the preset postpartum haemorrhage score value, then it is non-to generate uterus
The therapeutic scheme of severe postpartum hemorrhage, so as to according to the therapeutic scheme of the not serious postpartum haemorrhage in uterus to the Placenta acrreta patient
It is treated;
Wherein, the preset excision uterus score value is greater than the preset postpartum haemorrhage score value.
The therapeutic device of the Placenta acrreta patient provided according to embodiments of the present invention a kind of, comprising:
Module is obtained, for obtaining the essential information and Ultrasonic tomography performance information of Placenta acrreta patient;
Computing module, for being planted according to the essential information, the Ultrasonic tomography performance information and preset placenta
Enter degree grade form, calculates the Placenta acrreta degree score value of the Placenta acrreta patient;
Module is treated, for being controlled accordingly according to the Placenta acrreta degree score value the Placenta acrreta patient
It treats.
Preferably, the essential information includes age, pregnancy number, abortion history, Cesarean esction number and endometrium damage
Hurt history;The Ultrasonic tomography performance information includes placental presentation, low echo, placenta and mesometrium boundary, uterus in placenta
Abnormal blood flow signal after muscle layer echo continuity, perimetrium and bladder boundary, placenta involves bladder sign and involves uterine neck
Sign.
Preferably, further includes: establish Placenta acrreta degree grade form module, suffer from for collecting and recording different Placenta acrretas
The essential information and Ultrasonic tomography performance information of person, and by the essential information and Ultrasonic tomography performance letter
Different score values is respectively set in breath, and establishing includes the essential information, the Ultrasonic tomography performance information and scoring
The Placenta acrreta degree grade form of numerical value.
The scheme provided according to embodiments of the present invention passes through the essential information and Ultrasonic tomography table to Placenta acrreta patient
Existing related data is integrated and is handled, and further progress classification of severity, for instructing different degrees of Placenta acrreta
The selection of therapeutic modality facilitates the reasonable distribution of medical resource, and it is sufficiently preoperative to provide time progress for cooperation of multiple sciences diagnosis and treatment
Assessment, so as to reduce the generation of serious complications, and can improve the accuracy of Placenta acrreta pre-natal diagnosis.
Detailed description of the invention
Fig. 1 is the treatment method flow chart of Placenta acrreta patient provided in an embodiment of the present invention a kind of;
Fig. 2 is the therapeutic device schematic diagram of Placenta acrreta patient provided in an embodiment of the present invention a kind of;
Fig. 3 is the treatment method flow chart of Placenta acrreta patient provided in an embodiment of the present invention.
Specific embodiment
Below in conjunction with attached drawing to a preferred embodiment of the present invention will be described in detail, it should be understood that described below is excellent
Select embodiment only for the purpose of illustrating and explaining the present invention and is not intended to limit the present invention.
Fig. 1 is the treatment method flow chart of Placenta acrreta patient provided in an embodiment of the present invention a kind of, as shown in Figure 1, packet
It includes:
Step S101: the essential information and Ultrasonic tomography performance information of Placenta acrreta patient are obtained;
Step S102: according to the essential information, the Ultrasonic tomography performance information and preset Placenta acrreta journey
Grade form is spent, the Placenta acrreta degree score value of the Placenta acrreta patient is calculated;
Step S103: the Placenta acrreta patient is treated accordingly according to the Placenta acrreta degree score value.
Wherein, the essential information includes age, pregnancy number, abortion history, Cesarean esction number and endometrial impairment
History;The Ultrasonic tomography performance information includes placental presentation, low echo, placenta and mesometrium boundary, uterus muscle in placenta
Abnormal blood flow signal after layer echo continuity, perimetrium and bladder boundary, placenta involves bladder sign and involves uterine neck sign
As.
The embodiment of the present invention it is described obtain Placenta acrreta patient essential information and Ultrasonic tomography performance information before,
Further include: collect and record the essential information and Ultrasonic tomography performance information of different Placenta acrreta patients;By to the base
Different score values is respectively set in this information and the Ultrasonic tomography performance information, and establishing includes the essential information, institute
State the Placenta acrreta degree grade form of Ultrasonic tomography performance information and score value.
Wherein, described according to the essential information, the Ultrasonic tomography performance information and preset Placenta acrreta journey
Grade form is spent, the Placenta acrreta degree score value for calculating the Placenta acrreta patient includes: according to the Placenta acrreta patient
Ultrasonic tomography performance information and preset Placenta acrreta degree grade form, judge that the Placenta acrreta patient is penetrability tire
Disk implantation or placenta increta implantation;If judge that the Placenta acrreta patient is placenta increta implantation, reservation is generated
The reservation of the Placenta acrreta patient uterine cuts off therapeutic scheme, so as to according to the reservation therapeutic scheme to the Placenta acrreta
Patient treats;If judge that the Placenta acrreta patient is placenta percreta implantation, according to the Placenta acrreta patient
Essential information, the Ultrasonic tomography performance information and preset Placenta acrreta degree grade form, calculate the placenta and plant
Enter the Placenta acrreta degree score value of patient.
Specifically, described plant according to the Ultrasonic tomography performance information and preset placenta of the Placenta acrreta patient
Enter degree grade form, judges that the Placenta acrreta patient is placenta percreta implantation or placenta increta implantation includes: basis
The Ultrasonic tomography performance information of the Placenta acrreta patient and preset Placenta acrreta degree grade form, calculate the placenta
The Ultrasonic tomography for being implanted into patient shows score value, and Ultrasonic tomography performance score value is commented with preset Placenta acrreta
Score value is compared;When Ultrasonic tomography performance score value is greater than the preset Placenta acrreta score value, then judge
The Placenta acrreta patient is placenta percreta implantation;When Ultrasonic tomography performance score value is no more than described preset
When Placenta acrreta score value, then judge that the Placenta acrreta patient is placenta increta implantation.
Specifically, described control the Placenta acrreta patient according to the Placenta acrreta degree score value accordingly
Treatment includes: to be compared the Placenta acrreta degree score value with preset excision uterus score value;When the Placenta acrreta
When degree score value is greater than the preset excision uterus score value, then the excision for cutting off the Placenta acrreta patient uterine is generated
Therapeutic scheme, to be treated according to the excision therapeutic scheme to the Placenta acrreta patient;When the Placenta acrreta journey
When spending score value no more than the preset excision uterus score value, then the reservation for retaining the Placenta acrreta patient uterine is generated
Therapeutic scheme is cut off, to treat according to the reservation therapeutic scheme to the Placenta acrreta patient.
Wherein, it is described according to the reservation therapeutic scheme to the Placenta acrreta patient carry out treatment include: by the tire
Disk implantation degree score value is compared with preset postpartum haemorrhage score value;When the Placenta acrreta degree score value is greater than institute
When stating preset postpartum haemorrhage score value, then the therapeutic scheme of uterus severe postpartum hemorrhage is generated, seriously to produce according to uterus
The therapeutic scheme of bleeding treats the Placenta acrreta patient afterwards;When the Placenta acrreta degree score value is no more than described
When preset postpartum haemorrhage score value, then the therapeutic scheme of the not serious postpartum haemorrhage in uterus is generated, so as to not serious according to uterus
The therapeutic scheme of postpartum haemorrhage treats the Placenta acrreta patient;Wherein, the preset excision uterus score value is big
In the preset postpartum haemorrhage score value.
Fig. 2 is the therapeutic device schematic diagram of Placenta acrreta patient provided in an embodiment of the present invention a kind of, as shown in Fig. 2, packet
It includes: obtaining module 201, computing module 202 and treatment module 203.
Wherein, the acquisition module 201, for obtaining the essential information and Ultrasonic tomography performance letter of Placenta acrreta patient
Breath;The computing module 202, for according to the essential information, the Ultrasonic tomography performance information and preset placenta
Implantation degree grade form calculates the Placenta acrreta degree score value of the Placenta acrreta patient;The treatment module 203, is used for
The Placenta acrreta patient is treated accordingly according to the Placenta acrreta degree score value.
Wherein, the essential information includes age, pregnancy number, abortion history, Cesarean esction number and endometrial impairment
History;The Ultrasonic tomography performance information includes placental presentation, low echo, placenta and mesometrium boundary, uterus muscle in placenta
Abnormal blood flow signal after layer echo continuity, perimetrium and bladder boundary, placenta involves bladder sign and involves uterine neck sign
As.
The embodiment of the invention also includes: Placenta acrreta degree grade form module is established, for collecting and recording different placentas
It is implanted into the essential information and Ultrasonic tomography performance information of patient, and by the essential information and the Ultrasonic tomography
Performance information is respectively set different score values, establish comprising the essential information, the Ultrasonic tomography performance information with
And the Placenta acrreta degree grade form of score value.
The essential information of Placenta acrreta patient can inquire by medical history and obtain that Ultrasonic tomography performance can pass through ultrasound diagnosis
It obtains, by the essential information of Placenta acrreta patient, (age, pregnancy number, abortion history, Cesarean esction history number and endometrium are damaged
Hurt history) and Ultrasonic tomography performance (low echo, placenta and mesometrium boundary, mesometrium echo in placental presentation, placenta
Abnormal blood flow signal after continuity, perimetrium and bladder boundary, placenta involves bladder sign and involves uterine neck sign) it is defeated
Enter program.Different numerical value is all imparted in the program to indices, as shown in table 1, is then added every numerical value
The scoring that the patient suffers from Placenta acrreta is obtained, classification of severity further then is carried out to points-scoring system, as shown in Figure 2.It is right
Processing after classification.For example, it is contemplated that Placenta acrreta is very serious, it is proposed that Cesarean esction directly cuts off uterus simultaneously, or in art
Have instrument and the related personnel in excision uterus.
As shown in table 1, it includes: all to assign to the indices in essential information that different numerical value is all imparted to indices
It gives different numerical value and all assigns different numerical value to the indices in Ultrasonic tomography performance information.
Table 1: Placenta acrreta degree grade form
Specifically, all assigning different numerical value to the indices in essential information includes: that the age is divided into two
Stage, first stage assign numerical value 0, and second stage assigns numerical value 1;For example dividing the first stage at age is less than 35 years old the
Two-stage is not less than 35 years old.Pregnancy number is divided into two stages, the first stage assigns numerical value 0, and second stage assigns number
Value 1;For example the first stage of pregnancy number is divided as less than 3 times, second stage is not less than 3 times.Whether abortion history is by having stream
It produces history to divide, it is 0 that numerical value will be assigned without abortion history, and having abortion history to assign numerical value is 1.Whether endometrial impairment history is by having miscarriage
History divides, and assigning ametria inner film injury history to numerical value is 0, and having endometrial impairment history to assign numerical value is 1.By Cesarean esction history time
Number is divided into four-stage, and the first stage assigns numerical value 0, and second stage assigns numerical value 1, and the phase III assigns numerical value 2, fourth order
Section assigns numerical value 3;For example the first stage of division Cesarean esction history number is 0 time, second stage is 1 time, and the phase III is 2 times,
Fourth stage is greater than 2 times.
Specifically, to the indices in Ultrasonic tomography performance information all assign different numerical value include: will be preposition
Placenta is divided into four-stage, and the first stage assigns numerical value 0, and second stage assigns numerical value 1, and the phase III assigns numerical value 2, and the 4th
Stage assigns numerical value 3;For example the first stage of placental presentation is divided as nothing, second stage is marginality, and the phase III is part
Property, fourth stage is central.Echo low in placenta is divided into three phases, the first stage assigns numerical value 0, and second stage is assigned
Numerical value 1 is given, the phase III assigns numerical value 2;Such as divide placenta in the hypoechoic first stage be nothing, second stage is edge
Property, the phase III is that fusion is levied with boiling water in flakes.It is three phases by placenta and mesometrium boundary line delimitation, the first stage assigns
Numerical value 0, second stage assign numerical value 1, and the phase III assigns numerical value 2;For example divide the first rank of placenta and mesometrium boundary
Section be it is clear, second stage be it is fuzzy, the phase III be disappearance.Mesometrium echo continuity is divided into three phases, the
One stage assigned numerical value 0, and second stage assigns numerical value 1, and the phase III assigns numerical value 2;For example division mesometrium echo is continuous
Property first stage be it is continuous, second stage be interrupt, the phase III be disappear.It is three by perimetrium and bladder boundary line delimitation
A stage, first stage assign numerical value 0, and second stage assigns numerical value 1, and the phase III assigns numerical value 2;For example divide perimetrium
First stage with bladder boundary be it is clear, second stage be it is fuzzy, the phase III be disappear.By abnormal blood flow signal after placenta
Three phases are divided into, the first stage assigns numerical value 0, and second stage assigns numerical value 1, and the phase III assigns numerical value 2;Such as placenta
The first stage of abnormal blood flow signal is nothing afterwards, and it is agglomerating that second stage is that blood flow increases, and the phase III is transboundary blood vessel.Involve wing
Guang sign by whether have involve bladder sign divide, will without involve bladder sign assign numerical value be 0, have involve bladder sign imparting
Numerical value is 1.Involve uterine neck sign by whether have involve uterine neck sign divide, will without involve uterine neck sign assign numerical value be 0, have tired
And it is 1 that uterine neck sign, which assigns numerical value,.
Fig. 3 is the treatment method flow chart of Placenta acrreta patient provided in an embodiment of the present invention, as shown in Figure 3, comprising:
Step 1: according to the Ultrasonic tomography performance information of the Placenta acrreta patient and preset Placenta acrreta degree
Grade form (table 1) judges that the Placenta acrreta patient is placenta percreta implantation or placenta increta implantation;
According to the Ultrasonic tomography performance information of the Placenta acrreta patient and preset Placenta acrreta degree grade form,
Calculate the Placenta acrreta patient Ultrasonic tomography performance score value, and by the Ultrasonic tomography performance score value with it is preset
Placenta acrreta score value (such as 6 points in Fig. 3) be compared;When Ultrasonic tomography performance score value is greater than described pre-
When the Placenta acrreta score value set, then judge that the Placenta acrreta patient is placenta percreta implantation;When the ultrasonic image
When learning performance score value no more than the preset Placenta acrreta score value, then judge that the Placenta acrreta patient is implantable
Placenta acrreta.
Step 2: if judge that the Placenta acrreta patient is placenta percreta implantation, according to the Placenta acrreta patient
Essential information, the Ultrasonic tomography performance information and preset Placenta acrreta degree grade form, calculate the placenta and plant
Enter the Placenta acrreta degree score value of patient.
Step 3: by the Placenta acrreta degree score value and preset excision uterus score value (such as 10 points in Fig. 3)
It is compared;When the Placenta acrreta degree score value is greater than the preset excision uterus score value, then excision institute is generated
State the excision therapeutic scheme of Placenta acrreta patient uterine, so as to according to the excision therapeutic scheme to the Placenta acrreta patient into
Row treatment;When the Placenta acrreta degree score value is no more than the preset excision uterus score value, then generates and retain institute
The reservation excision therapeutic scheme of Placenta acrreta patient uterine is stated, to suffer from according to the reservation therapeutic scheme to the Placenta acrreta
Person treats.
Step 4: if judge that the Placenta acrreta patient is placenta increta implantation, generating and retain the Placenta acrreta
The reservation of patient uterine cuts off therapeutic scheme, to control according to the reservation therapeutic scheme the Placenta acrreta patient
It treats;
Step 5: the Placenta acrreta patient being treated according to the reservation therapeutic scheme.
The Placenta acrreta degree score value and preset postpartum haemorrhage score value (such as 8 points in Fig. 3) are compared
Compared with;When the Placenta acrreta degree score value is greater than the preset postpartum haemorrhage score value, then uterus serious postpartum is generated
The therapeutic scheme of bleeding, to be treated according to the therapeutic scheme of uterus severe postpartum hemorrhage to the Placenta acrreta patient;
When the Placenta acrreta degree score value is no more than the preset postpartum haemorrhage score value, then uterus not serious postpartum is generated
The therapeutic scheme of bleeding, to control according to the therapeutic scheme of the not serious postpartum haemorrhage in uterus the Placenta acrreta patient
It treats.
The scheme provided according to embodiments of the present invention, can high risk factor and ultrasound to Placenta acrreta patient by this program
The related data of Radiologic imaging is integrated and is handled, and further progress classification of severity, for instructing in various degree
The selection of Placenta acrreta therapeutic modality facilitates the reasonable distribution of medical resource, provides time progress for cooperation of multiple sciences diagnosis and treatment
Abundant preoperative evaluation, so as to reduce the generation of serious complications.
Although describing the invention in detail above, but the invention is not restricted to this, those skilled in the art of the present technique
It can be carry out various modifications with principle according to the present invention.Therefore, all to be modified according to made by the principle of the invention, all it should be understood as
Fall into protection scope of the present invention.
Claims (3)
1. a kind of processing unit of Placenta acrreta patient characterized by comprising
Module is obtained, for obtaining the essential information and Ultrasonic tomography performance information of Placenta acrreta patient;
Computing module, for according to the essential information, the Ultrasonic tomography performance information and preset Placenta acrreta journey
Grade form is spent, the Placenta acrreta degree score value of the Placenta acrreta patient is calculated;
Module is treated, for being treated accordingly according to the Placenta acrreta degree score value to the Placenta acrreta patient.
2. processing unit according to claim 1, which is characterized in that the essential information includes age, pregnancy number, stream
Produce history, Cesarean esction number and endometrial impairment history;The Ultrasonic tomography performance information includes placental presentation, low in placenta
Abnormal blood flow after echo, placenta and mesometrium boundary, mesometrium echo continuity, perimetrium and bladder boundary, placenta
Signal involves bladder sign and involves uterine neck sign.
3. processing unit according to claim 2, which is characterized in that further include: establish Placenta acrreta degree grade form mould
Block, for collecting and record the essential information and Ultrasonic tomography performance information of different Placenta acrreta patients, and by institute
It states essential information and different score values is respectively set in the Ultrasonic tomography performance information, establishing includes the basic letter
The Placenta acrreta degree grade form of breath, the Ultrasonic tomography performance information and score value.
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CN110988352A (en) * | 2019-11-11 | 2020-04-10 | 余波澜 | Kit for auxiliary detection of placenta implantation and application thereof |
CN110988352B (en) * | 2019-11-11 | 2023-06-27 | 广州医科大学附属第三医院(广州重症孕产妇救治中心、广州柔济医院) | Kit for auxiliary detection of placenta implantation and application thereof |
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