影响胎盘植入凶险程度的临床高危因素分析  

Analysis the Clinical Risk Factors of Placenta Increta/Percreta Against Acreta

作　　者：陈运山[1] 赵扬玉[1] 王妍[1] 种轶文[1] 盛晴[1] 

机构地区：[1]北京大学第三医院,北京100191

出　　处：《实用妇产科杂志》2015年第12期916-919,共4页Journal of Practical Obstetrics and Gynecology

基　　金：首都临床特色应用研究专项基金(编号:2013053)

摘　　要：目的:探讨影响胎盘植入凶险程度的临床高危因素。方法:对北京大学第三医院2003年1月至2014年12月收治的产后诊断为胎盘植入的633例病例进行回顾性调查,采用Logistic回归方法对影响胎盘植入凶险程度的临床高危因素进行单因素和多因素分析。结果:重型胎盘植入(包括穿透型及植入型)69例,轻型(粘连型)胎盘植入564例。单因素回归分析结果提示,轻型组与重型组比较,孕产妇在孕次、产次、宫腔操作次数、瘢痕子宫、多胎妊娠和前置胎盘间差异有统计学意义(P<0.05)。多因素回归分析结果提示,瘢痕子宫、多胎妊娠和前置胎盘是影响胎盘植入凶险程度的独立高危因素(P<0.05)。结论:有剖宫产史或合并前置胎盘以及多胎妊娠孕妇应加强监测,需警惕重型胎盘植入的发生。Objective： To explore the clinical risk factors for placenta increta/percreta against acreta. Methods：A retrospective study was used to obtain histories of 633 patients with diagnosis of placenta acreta,increta / percreta from Jan 2003 to Dec 2014 in obstetric and gynecology department of Peking university third hospital,using logistic regression method to single factor and multiple factors analysis,to find placenta increta / percreta against acreta high risk factors. Results： There were 69 cases of placenta increta / percreta（ severe group） and 564 cases of placenta acreta（ mild group）. Single factor regression analysis results suggested that placenta previa,pregnant times,production times,scared uterus,cavity operation times,multiple pregnancy was statistically differentbetween the two groups（ P 〈0. 05）. Further multiple factors regression analysis result showed that placenta previa,scared uterus,multiple pregnancy were important high risk factors for placenta increta / percreta against acreta（ P 〈0. 05）. Conclusions： All pregnant women with placenta previa or caesarean,especially those combined with multiple pregnancy should receive strengthen monitoring,placenta increta and percreta should be vigilant.

关 键 词：重型胎盘植入 高危因素 瘢痕子宫 前置胎盘 

分 类 号：R714.462[医药卫生—妇产科学]