胎盘部位超常反应34例临床和病理分析  

Clinical and pathological analysis of 34 cases with exaggerated placental site

作　　者：侯锐[1] 姜罗[2] 林蓓[1] 张淑兰[1] 

机构地区：[1]中国医科大学附属盛京医院妇产科,沈阳110004 [2]中国医科大学附属盛京医院超声科,沈阳110004

出　　处：《中国医师进修杂志》2012年第30期6-8,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的总结胎盘部位超常反应（EPS）的临床和病理特点，探讨其发病规律及诊治策略。方法对34例EPS患者的临床资料进行回顾性分析。结果34例患者中，足月剖宫产11例，正常分娩2例，自然或人工流产21例；有妊娠史31例；行子宫切除术15例，刮宫术13例，宫腔镜探查病灶电切术6例，经治疗后全部患者均痊愈。结论EPS无法在产前、产时诊断，均依靠病理确诊。在分娩或流产后出血经常规处理效果不佳时，应考虑存在EPS的可能。如出血多，及时切除子宫是其有效的治疗手段，可以挽救患者生命；如出血不多，可行刮宫或官腔镜探查术处理病灶，治疗效果显著，可有效避免子宫切除。Objective To summarize the clinical and pathological features of exaggerated placental site （EPS）,explore its pathogenesis regularity, diagnosis and treatment strategies. Methods The clinical data related to 34 patients with EPS were analyzed retrospectively. Results In 34 patients, 11 patients performed full-term cesarean section, 2 patients performed normal vaginal delivery,the other 21 patients had abortion. Thirty-one patients had pregnancy history. Fifteen patients performed hysterectomy, 13 patients performed dilatation and curettage,6 patients performed exploratory hysteroscopy and lesions resection. All the patients survived after treatment. Conclusions The patients can not be diagnosed in the antepartum and intrapartum, but can be diagnosed relying on the pathological diagnosis. When it is ineffective to stop bleeding after delivery or abortion by conventional treatment,we should consider the possibility of EPS. Timely perform hysterectomy is the effective method to stop bleeding, can save the life of patients. If bleeding is not much, curettage or exploratory hysteroscopy can get a significant effective treatment and avoid hysterectomy.

关 键 词：胎盘疾病 胎盘部位超常反应 滋养细胞 

分 类 号：R714.5[医药卫生—妇产科学]