不典型胎盘早剥的早期识别体会  

Early recognition of atypical placental abruption

作　　者：金渝 吕元方 Jin Yu;Lv Yuanfang(Department of Obstetrics and Gynecology,People' s Hospital of Qichun County,Huanggang,Hubei,435300,China)

机构地区：[1]蕲春县人民医院妇产科,湖北黄冈435300

出　　处：《当代医学》2019年第10期107-109,共3页Contemporary Medicine

摘　　要：目的总结并归纳不典型胎盘早剥的早期识别方法。方法选取2016年2月至2018年2月期间的10 000例孕产妇为研究对象,统计胎盘早剥患者的例数,记录胎盘早剥发生率。回顾性分析所有胎盘早剥患者的临床资料,分析胎盘早剥发生的诱因、患者临床表现。所有患者均采用产科彩超、CT检查,以最终病理结果为金标准,比较两种检查方式对于胎盘早剥的诊断符合率、漏诊率和误诊率,分析最适合胎盘早剥疑似患者的检查方式。观察患者最终母婴结局,记录胎盘早剥患者的死亡率及围产儿的健康状况。结果本研究10 000例孕产妇中,出现胎盘早剥患者70例,胎盘早剥发生率为0.70%(70/10 000);子痫前期,子痫,高血压,胎膜早破与胎盘早剥之间的关系,差异均有统计学意义(P<0.05),子痫,高血压,胎膜早破均为胎盘早剥的危险因素;彩超检查在诊断符合率、漏诊率和误诊率方面,分别为95.71%,1.43%和5.71%,均明显优于CT检查的82.86%,10.00%和18.57%,差异均有统计学意义(P<0.05);胎盘早剥患者产后出血发生率为28.57%(20/70);新生儿低体质量发生率和早产率分别为5.71%(4/70)和8.57%(6/70);产妇均未发生死亡,围生儿死亡1例,死亡率为1.43%(1/70)。结论不典型胎盘早剥严重影响孕产妇的生活质量及其母婴结局,在治疗不典型胎盘早剥时,彩超的应用具有较高的临床价值,结合胎盘早剥的危险因素,可准确诊断出胎盘早剥,有利于胎盘早剥患者的及早诊治,可以被推广应用。Objective To summarize and summarize the early identification methods of atypical placental abruption. Methods 10,000 pregnant and lying-in women from February 2016 to February 2018 were selected as the research objects, the number of patients with placental abruption was counted, and the incidence of placental abruption was recorded. The clinical data of all patients with placental abruption were retrospectively analyzed, and the causes and clinical manifestations of placental abruption were analyzed. All patients were examined by obstetric color Doppler ultrasound and CT, and the final pathological results were taken as the gold standard. The diagnostic coincidence rate, missed diagnosis rate and misdiagnosis rate of the two examination methods for placental abruption were compared, and the examination method most suitable for suspected patients with placental abruption was analyzed. The final maternal and infant outcomes of patients were observed, and the mortality rate of patients with placental abruption and the health status of perinatal infants were recorded. Results Among the 10,000 pregnant and lying-in women in this study, 70 cases had placental abruption, and the incidence rate of placental abruption was 0.70%(70/10,000). The relationship between preeclampsia, eclampsia, hypertension, premature rupture of membranes and placental abruption is statistically significant (P<0.05). Eclampsia, hypertension and premature rupture of membranes are all risk factors for placental abruption. The diagnostic coincidence rate, missed diagnosis rate and misdiagnosis rate of color Doppler ultrasound examination are 95.71%, 1.43% and 5.71% respectively, which are obviously better than 82.86%, 10.00% and 18.57% of CT examination, and the differences are statistically significant (P<0.05). The incidence of postpartum hemorrhage in patients with placental abruption was 28.57%(20/70);The incidence rate of low body mass and premature birth were 5.71%(4/70) and 8.57%(6/70) respectively. No maternal deaths occurred, and one pe

关 键 词：不典型胎盘早剥 发生率 症状表现 诊断 母婴结局 

分 类 号：R714.2[医药卫生—妇产科学]