胎盘滞留“幸存者”与“死亡者”的对比研究  

A contrast study on survivor and the dead in placental retention

作　　者：金真菊 

机构地区：[1]贵州省疾控中心妇保所,贵州贵阳550004

出　　处：《中国妇幼健康研究》2010年第2期155-158,共4页Chinese Journal of Woman and Child Health Research

基　　金：贵州省卫生厅科学技术基金课题资助项目（gzwk2008-1-043）;贵州省疾病预防控制中心科学技术基金课题资助项目（2008-08）

摘　　要：目的对胎盘滞留相关因素进行研究，为有效防治孕产妇死亡提供基础数据和依据。方法选择贵州省“降消项目”县4年间发生在县乡级医院住院孕产妇的两种特殊妊娠结局：其一，胎盘滞留导致38例孕产妇死亡；其二，36例孕产妇发生胎盘滞留得到了良好救治而存活。将上述“幸存者”与“死亡者”进行分析比较。结果两组在民族（χ2＝24.970）、阴道流血量（χ2=12.180）、胎儿娩出后处理胎盘时间（χ2=7.785）、产前产后入院时间（χ2=13.790）、胎盘因素异常原因、胎盘娩出异常处理方法、治疗抢救情况等均有明显差异（均P〈0.05）。结论提高县乡级产科适宜技术水平，正确掌握人工剥离胎盘及清宫术技巧。ObjectiveTo investigate the related factors of placentalretention, so as to provide basic dada and basis for effectively preventing maternal mortality. Methods The clinical data of 38 pregnant and parturient women who had dead from placental retention and 36 survival pregnant and parturient women who had been successfully rescued in countylevel and townshiplevel hospitals of 58 “maternal mortality reducing and extincting project”counties in Guizhou province in a 4year period were retrospectively analyzed and compared. Results In nationaltity （Han nationality or minority nationality）（χ2=24.970, P〈0.05）, vaginal bleeding volume（χ2=12.180, P〈0.05）, placenta management time after delivery of the neonate（χ2=7.785, P〈0.05）, causes of placental abnormalities, abnormal management after plcenta delivery and treatment and rescue situation, there were significant differences between the two groups. Conclusion Raising obstetric suitable technical levels of the obstetric personnel in countylevel and townshiplevel hospitals, correctly grasping skills of manual removal of placenta and intrauterine cavity cleaning operation（intrauterine curetting operation）, improving rescure ability for obstetric critical, emergent and severe patients, consummating tertiary MCH network, strictly grasping transfer treatment indications and timely and resolutelyperforming hysterectomy on those patients with lifethreatening sever uterine bleeding are all key measures to reduce maternal mortality rate.

关 键 词：胎盘滞留 幸存 死亡 对比研究 

分 类 号：R714.56[医药卫生—妇产科学] R173[医药卫生—临床医学]