凶险性前置胎盘并发症预防护理的研究现状

Research Status of Preventive Nursing for Complications of Pernicious Placenta Previa

摘要: 目的：总结凶险性前置胎盘各类并发症的预防护理措施及最新研究进展，为临床构建规范化、系统化的并发症防控护理体系提供参考依据，进一步降低孕产妇危重并发症发生率、改善母婴妊娠结局。方法：系统检索中国知网、万方、维普、PubMed等数据库2018~2026年关于凶险性前置胎盘并发症、预防干预、围产期护理、风险管控的相关中英文文献，筛选高质量临床研究、综述、专家共识及对照研究，对纳入文献的护理措施、干预模式、临床效果进行归纳整理与综合分析。结果：凶险性前置胎盘高发大出血、胎盘植入、失血性休克、感染、下肢深静脉血栓、产后抑郁、胎儿早产等多重并发症，病情凶险、救治难度大。目前临床护理已由传统常规护理逐步转向多学科协作、全程分层风险管控、精细化预防干预、心理干预与快速康复的综合护理模式。规范化产前风险筛查、孕期止血保胎护理、围手术期精准急救配合、术后并发症靶向预防、全程心理干预可显著降低大出血、子宫切除、血栓、感染等不良事件发生率，提升护理质量与救治成功率。结论：多元化、全程化的预防护理干预是降低凶险性前置胎盘并发症、保障母婴安全的关键。目前临床护理仍存在基层干预不规范、个体化防控不足、随访体系不完善等问题，未来需进一步细化分层护理方案、推广循证护理模式，完善全周期并发症预防护理体系。

Abstract: Objective: To summarize the latest research progress and preventive nursing measures for various complications of pernicious placenta previa, so as to provide a reference for constructing a standardized and systematic clinical nursing prevention and control system, and further reduce the incidence of severe maternal complications and improve maternal and fetal pregnancy outcomes. Methods: Chinese and English literatures regarding complications, preventive intervention, perinatal nursing and risk management of pernicious placenta previa published from 2018 to 2026 were systematically retrieved from CNKI, Wanfang, VIP, PubMed and other databases. High-quality clinical studies, reviews, expert consensus and controlled studies were screened, and the included literatures were comprehensively analyzed and summarized in terms of nursing measures, intervention modes and clinical efficacy. Results: Pernicious placenta previa is associated with multiple high-incidence complications including massive hemorrhage, placenta accreta, hemorrhagic shock, infection, deep venous thrombosis of lower extremities, postpartum depression and fetal preterm birth, which are critical and difficult to treat. Clinical nursing has gradually transformed from traditional routine nursing into a comprehensive nursing mode featuring multidisciplinary collaboration, whole-process hierarchical risk management, refined preventive intervention, psychological intervention and enhanced recovery after surgery. Standardized prenatal risk screening, hemostatic and tocolytic nursing during pregnancy, precise perioperative emergency cooperation, targeted postoperative complication prevention and whole-course psychological intervention can significantly reduce the incidence of adverse events such as massive hemorrhage, hysterectomy, thrombosis and infection, and improve nursing quality and treatment success rate. Conclusion: Diversified and whole-process preventive nursing intervention is the key to reducing complications of pernicious placenta previa and ensuring maternal and infant safety. Current clinical nursing still has deficiencies such as non-standardized grassroots intervention, insufficient individualized prevention and control, and imperfect follow-up systems. It is necessary to further refine hierarchical nursing protocols, promote evidence-based nursing models, and improve the whole-cycle preventive nursing system for complications in the future.