胎盘早剥早期诊断的临床研究  

Clinical research of early diagnosis in placental abruption

作　　者：黄睿[1] 胡鹭萍[2] 

机构地区：[1]厦门市第二医院产科,362011 [2]厦门市第二医院眼科,362011

出　　处：《中国实用医药》2015年第11期38-39,共2页China Practical Medicine

摘　　要：目的探讨胎盘早剥的临床特点和早期诊断方法 ,以减少漏诊及误诊。方法 40例胎盘早剥患者根据胎盘剥离面积,将患者分为轻型组(26例)和重型组(14例),观察两组患者胎盘早剥的发病诱因、临床表现、胎心监护、B超、分娩方式和母婴预后。结果 1胎盘早剥的临床表现主要为胎心监护异常、阴道出血、B超异常等;2重型组在产后出血、子宫胎盘卒中、失血性休克、死胎、新生儿窒息的发生率方面均显著高于轻型组(P<0.05);3本组误诊率为27.50%,漏诊率为37.50%。结论胎盘早剥诱因比较多,预后差,重在预防,临床诊断中,应综合利用B超、胎心监护和临床表现,做到早期诊断,早期干预,减少漏诊及误诊,改善预后,保障母婴安全。Objective To investigate the clinical characteristics and early diagnosis method of placental abruption, in order to reduce missed diagnosis and misdiagnosis. Methods A total of 40 placental abruption patients were divided into mild group （26 cases） and severe group （14 cases） by their abruption area. The observation was made on inducement, clinical manifestations, fetal heart rate monitoring, B ultrasound, delivery mode, and prognosis of mother and infant. Results （1） Clinical manifestations of placental abruption mainly included abnormal fetal heart rate monitoring, colporrhagia, and abnormal B ultrasound. （2） Severe group had significantly higher incidences of postpartum hemorrhage, uteroplacental apoplexy, hemorrhagic shock, stillbirth, and neonatal asphyxia than mild group （P〈0.05）. （3） The misdiagnosis rate was 27.50%, and the missed diagnosis rate was 37.50%. Conclusion Placental abruption has multiple inducements, and its bad prognosis requires important pievention. In clinical diagnosis, it is necessary for combination of B ultrasound, fetal heart rate monitoring, and clinical manifestation. Early diagnosis and early intervention can reduce missed diagnosis and misdiagnosis, improve prognosis, and guarantee safety of mother and infant.

关 键 词：胎盘早剥 早期诊断 胎心监护 B超 临床表现 

分 类 号：R714.2[医药卫生—妇产科学]