胎盘早剥晚期早产儿临床特征及干预分析  

The clinical characteristics and therapy of the late-preterm neonates with placental abruption

作　　者：许靖[1,2] 李秋平[2] 孔祥永[2] 王自珍[2] 周丽[2] 杨璐[1] 马兴娜[2] 梅亚波[2] 刘敬[2] 封志纯[2] 

机构地区：[1]南方医科大学八一临床医学院附属八一儿童医院,北京100007 [2]北京军区总医院附属八一儿童医院,北京100007

出　　处：《中国实用儿科杂志》2012年第5期371-374,共4页Chinese Journal of Practical Pediatrics

基　　金：首都特色临床医学技术发展研究(Z090507017709001)

摘　　要：目的总结胎盘早剥晚期早产儿的临床特点与治疗方案。方法从2009年10月至2011年5月从北京军区总医院附属八一儿童医院早产儿重症监护中心患儿资料中,根据入选条件,选取患儿83例,其中胎盘早剥37例为观察组,非胎盘早剥46例为对照组,进行回顾性分析。结果观察指标中,两组患儿比较,胎龄、多胎、胎膜早破史、出生体重、体重与胎龄匹配情况(小于胎龄儿或否)、母亲年龄、母亲妊娠糖尿病、新生儿窒息史、入院时活化部分凝血活酶时间(APTT)、D-二聚体(D-D)、输注悬浮红细胞、输注血浆及使用肝素指标差异有统计学意义(P<0.05)。结论胎盘早剥属于胎盘功能不全,多继发早产儿凝血功能异常,使用小剂量肝素、输注血浆防治效果理想。Objective To conclude the clinical characteristics of the late-preterm neonates with placental abruption and to build up the therapeutic protocol. Methods Retrospective analysis was conducted. According to enrolling qualifications , 83 subjects from the hospitalized children of the NICU of Bayi Children ’ s Hospital Affiliated to General Hospital of Beijing Military Command of PLA were enrolled from October 2009 to May 2011 , in which 37 late-preterm neonates were with placental abruption and 46 late-preterm neonates without placental abruption as the control group included. Results From clinical manifestations , lab and therapy data , significant differences were detected in gestational age , multiplets , premature rupture of membrane , birth weight , intrauterine growth retardation , mother age , mother gestational diabetes mellitus , asphyxia , APTT , D-dimer on admission , red cell transfusion , plasma transfusion and use of heparin between the observation group and control group （P 〈 0.05 ） . Conclusion Placental abruption is due to placental insufficiency , often resulting in coagulation disorder ; low-dose heparin as well as plasma transfusion can improve neonates ’ outcome.

关 键 词：胎盘早剥 婴儿 早产 肝素 

分 类 号：R72[医药卫生—儿科]