胎盘早剥的早期诊断(附67例临床分析)  

Early diagnosis of placental abruption in 67 cases

作　　者：胡艳[1] 张静媛[1] 

机构地区：[1]北京大学深圳医院妇产科,广东深圳518036

出　　处：《中国妇幼保健》2009年第33期4667-4670,共4页Maternal and Child Health Care of China

摘　　要：目的:探讨发病诱因、临床表现和超声检查对胎盘早剥的诊断意义。方法:对2005年1月～2008年5月北京大学深圳医院收治的67例胎盘早剥患者资料进行回顾性分析。结果:胎盘早剥发生率为0.78%,妊娠期高血压疾病、胎膜早破为其重要诱因,主要临床表现为阴道出血、持续性下腹痛、血性羊水、胎心率异常或消失。胎盘早剥产前诊断率为67.16%,B超检出率为60.94%,新生儿窒息发生率为35.82%,围产儿死亡率为14.29%,产后出血、子宫胎盘卒中及DIC发生率分别为28.36%、16.42%和7.46%。其中Ⅱ、Ⅲ度胎盘早剥患者的临床表现、产前诊断率、母儿并发症发病率明显高于Ⅰ度胎盘早剥,其差异具有统计学意义(P<0.05);但胎盘早剥患者中B超对前、侧壁胎盘与后壁胎盘的产前诊断率比较差异无统计学意义(P>0.05)。结论:胎盘早剥严重威胁母儿生命,应结合诱因、临床表现以及B超等辅助检查全面考虑,尽早对其作出正确诊断和处理。Objective： To explore the values of predisposing factors, clinical manifestations and ultrasonography in the diagnosis of placental abruption. Methods ： The clinical data of 67 cases with placental abruption were analyzed retrospectively from January 2005 to May 2008. Results： The incidence of placental abruption was 0. 78% , the main predisposing factors were hypertensive disorders complicating pregnancy and premature rupture of fetal membranes, the main clinical manifestations included vaginal hemorrhage, constant pain in lower abdomen, bloody aminiotic fluid, abnormality or disappearance of fetal heart rhythm. The antenatal diagnosis rate of placental abruption was 67. 16% , the detection rate of uhrasonography was 60. 94% , the incidence of newborn asphyxia was 35.82% , the perinatal mortality was 14. 29%. The incidences of postpartum hemorrhage, uterine apoplexy and DIC were 28.36% , 16. 42% and 7.46% , respectively. The clinical manifestations, antenatal diagnosis rate and incidences of complications of mothers and infants of patients with placental abruption Ⅱ,Ⅲ were significantly higher than those of patients with placental abruption Ⅰ （ P 〈 0.05 ） ; but there was no significant difference in the antenatal diagnosis rate of placental abruption with uhrasonography among anterior placenta, lateral placenta and posterior placenta （ P 〉 0.05 ） Conclusion： Placental abruption threatens the health of mothers and infants, predisposing factors, clinical manifestations and uhrasonography should be carried out to make correct diagnosis and appropriate treatment.

关 键 词：胎盘早剥 诊断 临床表现 超声检查 

分 类 号：R714.2[医药卫生—妇产科学]