目的：探讨多学科诊疗模式应用于凶险性前置胎盘的临床效果。方法：回顾分析由多学科协作团队对46例凶险性前置胎盘患者进行救治的情况。结果：46例患者剖宫产术前予预置血管球囊14例；术中行子宫压迫缝合术26例，宫腔球囊置入术37例，宫腔纱条填塞4例；术后行子宫动脉栓塞10例。41例患者保留子宫（89.13%），手术平均时间为（121.1±53.7） min，平均失血量为（1 680.4±1 194.2） ml。输血36例，其中自体回输血6例。术后转ICU 18例，术后平均住院天数（7.5±2.7） d，新生儿Apgar 1 min评分为（9.0±2.2）分，预后良好。结论：多学科协作诊疗为凶险性前置胎盘患者提供全面的医疗保障，是手术救治成功的关键，对产科危重症的诊治具有重要意义。

[1] TAKAHASHI H, OHKUCHI A, USUI R, et al. Matsubara-Takahashicervix-holding technique for massive postpartum hemorrhage inpatients with placenta previa with or without placenta accrete spectrum disorders[J]. Int J Gynaecol Obstet, 2018, 140(3):357-364.
[2] 谭虎, 陈敦金.美国妇产科医师协会与母胎医学会胎盘植入性疾病指南(2018年)解读[J]. 实用妇产科杂志, 2019, 35(10):739-742.
[3] 中华医学会围产医学分会.胎盘植入诊治指南(2015)[J]. 中华妇产科杂志, 2015, 5(12):26-31.
[4] 易小春, 张建平.胎盘原位保留治疗的感染问题[J]. 中华产科急救电子杂志, 2017(3):142-146.
[5] 何镭, 刘兴会.产科紧急子宫切除[J]. 实用妇产科杂志, 2018, 34(7):489-491.
[6] CHATTOPADHYAY S K, KHARIF H, SHERBEENI M M.Placenta praevia and accreta after previous caesarean section[J]. European Journal of Obstetrics Gynecology & Reproductive Biology, 1993, 52(3):151-156.
[7] SLAVOVA-AZMANOVA N S, JOHNSON C E, PLATELL C, et al. Peer review of cancer multidisciplinary teams: is it acceptable in Australia?[J]. Med J Aust, 2015, 202(3):144-147.
[8] 刘小晖, 董燕, 刘小玲, 等. 多学科协作诊疗模式在穿透性胎盘植入中的应用[J]. 国际妇产科学杂志, 2020, 47(6):666-669.
[9] PRIYANKA J, LIINA P, CHARIS B, et al. Society of Abdominal Radiology (SAR) and European Society of Urogenital Radiology (ESUR) joint consensus statement for MR imaging of placenta accreta spectrum disorders[J]. European Radiology, 2020, 30(5):2604-2615.
[10] ERIC J, DIOGO A.FIGO consensus guidelines on placenta accreta spectrum disorders: Introduction[J]. Int J Gynecol Obstet, 2018, 140:261-264
[11] JAUNIAUX E, ALFIREVIC Z, BHIDE A G, et al. Placenta praevia and placenta accreta: diagnosis and management[J]. BJOG:An Int J Ob & Gyn, 2019, 126(1):e2-e48.
[12] 侯宜萍, 周昔红, 石理红, 等. 凶险型前置胎盘植入的影响因素及妊娠结局[J]. 中南大学学报(医学版), 2020, 45(9):1074-1081.
[13] 种轶文, 张爱青, 王妍, 等. 超声评分系统预测胎盘植入凶险程度的价值[J]. 中华围产医学杂志, 2016, 19(9):705-709.
[14] 李晓凡, 余红军.MRI征象评分对胎盘种植异常的诊断价值[J]. 放射学实践, 2019, 34(12):1358-1363.
[15] 谢幸, 孔北华, 段涛.妇产科学[M]. 9版.北京:人民卫生出版社, 2018:208-209.
[16] JAUNIAUX E, COLLINS E, BURTON G J.Placenta accreta spectrum: pathophysiology and evidence-based anatomy for prenatal ultrasound imaging[J]. Am J Obstet Gynaecol, 2018, 218(1):75-87.
[17] 罗荣光, 关晏星.介入技术在PPP剖宫产术的应用[J/OL]. 中华介入放射学电子杂志, 2020, 8(3):269-275.
[18] DUBOIS J, GAREL L, GRIGNON A, et al. Placentapercreta: balloon occlusion and embolization of the internal iliac arteries to reduce intraoperative blood losses[J]. Am J Obstet Gynecol, 1997, 176(3):723-726.
[19] SHIH J C, LIU K L, SHYU M K.Temporary balloon occlusion of the common iliac artery:new approach to bleeding control during cesarean hysterectomy for placenta percreta[J]. Am J Obstet Gynecol, 2005, 193(5):1756-1758.
[20] PAULL J D, SMITH J, WILLIAMS L, et al. Balloon occlusion of the abdominal aorta during caesarean hysterectomy for placenta percreta[J]. Anaesth Intensive Care, 1995, 23(6):731-734.
[21] MEI Y W, LUO D, LIN Y H.Clinical application of prophylactic internal iliac artery balloon occlusion combined with uterine artery embolization in patients with abnormally invasive[J]. Matern Fetal Neonatal Med, 2018, 31(24):3287-3292.
[22] DUAN X H, WANG Y L, HAN X W, et al. Caesarean section combined with temporary aortic balloon occlusion followed by uterine artery embolisation for the management of placenta accreta[J]. Clin Radiol, 2015, 70(9):932-937.