胎盘早剥108例临床分析  

To clinical analysis 108 cases of placental abruption

作　　者：王玲君[1] 刘丽华[2] 李鹏[3] 金仲品[4] 

机构地区：[1]山东省滨州市博兴县人民医院妇产科,256500 [2]滨州市人民医院,256610 [3]滨州医学院附属医院,256603 [4]滨州职业学院,256600

出　　处：《中国医疗前沿》2012年第8期40-41,共2页China Healthcare Innovation

摘　　要：目的探讨胎盘早剥病例的临床特点,提高诊断率,改善母儿预后。方法回顾性分析初诊时误、漏诊的80例(A组)和初诊时确诊的28例(B组)临床资料。结果胎盘早剥发生率为0.58%,误(漏)诊率为74.07%;妊高征、胎膜早破及催产素应用不当是胎盘早剥的主要发病诱因,妊高征与机械因素B组多于A组,两组差异均有统计学意义(P<0.01);阴道流血、腰背胀痛、腹胀痛和血性羊水,B组明显多于A组,差异有统计学意义(P<0.01)。新生儿窒息、婴儿死亡,B组明显多于A组,差异有统计学意义(P<0.01)。结论胎盘早剥误(漏)诊的主要因素是:病情隐匿,诱因不明,症状不典型,B超检出率低。因此,产科医务人员需高度重视主诉,详细询问患者病史,细仔检查盆腔体征,尤其要严密观察产程进展中的每个变化,并采用B超或彩超动态监测变化,力求尽早明确诊断,及时处理以降低母儿并发症和病死率。Objective To study the placental abruption early cases of the clinical characteristics,diagnosis rate increase and improve the son prognosis.Methods A retrospective analysis of error diagnosis,most of the 80 cases（group A） and most of the confirmed 28 patients（group B） do clinical data.Results The incidence of placental abruption for 0.58%,mistakenly（leak） examine rate is 74.07%;Levy,high uteruses premature rupture of membranes broken and oxytocin improper application,is the main placental abruption of incentives,and high mechanical factors and uteruses for more than A group of group B,two groups are highly significant difference（P 0.01）;Vaginal bleeding,low back pain,abdominal distension painful and hemorrhagic amniotic fluid,group B significantly more than A group,A highly significant difference（P 0.01）.Neonatal asphyxia,the baby died,group B significantly more than A group,A highly significant difference（P 0.01）.Conclusion Abruption mistakenly（leak） examine is the main factor： is it conceals,and incentives are unknown,atypical symptoms,B ultrasonic detection rate caused by low.Therefore,obstetrician medical staff should be pay high attention to the complaints,detailed ask the patient history,fine son check pelvic signs,especially to close observation of the progress of the chosen every change,and adopts B ultrasound or color dopplar ultrasound dynamic monitoring changes,and strive to clear diagnosis as early as possible,deal with to reduce mother son complications,and mortality.

关 键 词：胎盘早剥 临床分析 早期诊断 

分 类 号：R714.46[医药卫生—妇产科学]