Abstract:

To summarize the perioperative nursing experience in a case of perioperative hemorrhage during cesarean section due to pernicious placenta previa with concurrent placenta implantation accompanied and severe polyhydramnios. Nursing key points：①to set up a multidisciplinary team before the operation，and work together to formulate a systematic intraoperative emergency plan；②to activate the intraoperative emergency plan，fully cooperate with the implementation of the rescue；to optimize the blood management process，to maintain the stability of the patient’s blood circulatory system；to implement a diversified nursing program，to minimize the risk of infection of the surgical site；to optimize the process of preterm asphyxiation rescue，to ensure that the child’s respiratory circulation is stable；③to strengthen the risk of postoperative thrombosis and hemorrhage，to strengthen the early warning and management of postoperative thrombosis and bleeding risk；to strengthen the risk prevention and monitoring management of acute colonic pseudo-obstruction；to apply the ‘5G+VR remote visiting service system’ to enhance patients’ emotional support. After multidisciplinary joint treatment and refined nursing care，the patient was discharged from the hospital on the seventh day after the operation，and both the mother and the child recovered well in the one-month follow-up after the operation.

Key words: Pernicious Placenta Previa, Amniotic Fluid, Cesarean Section, Obstetrical Nursing, Perioperative Nursing

摘要：

总结1例凶险性前置胎盘合并胎盘植入伴重度羊水过多患者剖宫产术中并发大出血的围手术期护理经验。护理要点：①术前组建多学科协作团队，共同拟订系统化术中应急预案；②启动术中应急预案，全力配合实施抢救；优化血液管理流程，维持血液循环系统稳定；实施多元化护理方案，最小化手术部位感染风险；优化早产儿窒息抢救流程，确保呼吸循环稳定；③强化术后血栓及出血风险的预警与管理；加强急性结肠假性梗阻的风险预防与监测管理；应用“5G+虚拟现实远程探视服务系统”，增强情感支持。经过多学科联合救治及精细化护理，患者术后7 d出院，术后2个月随访，母婴恢复良好。

关键词: 凶险性前置胎盘, 羊水过多, 剖宫产术, 产科护理, 围手术期护理