145例胎盘早剥及漏诊误诊原因分析  

The cause analysis of missed diagnosis and misdiagnosis of 145 pregnant women with placental abruption

作　　者：林蕾[1] 索冬梅[1] 林育娇[1] 郭绮棱[1] LIN Lei;SUO Dongmei;LIN Yujiao;GUO Yuling(Foshan Maternal and Child Health Care Hospital, Guangdong Province, 528000)

机构地区：[1]广东省佛山市妇幼保健院,528000

出　　处：《中国计划生育学杂志》2020年第3期408-411,共4页Chinese Journal of Family Planning

摘　　要：目的:探讨胎盘早剥发生临床表现、辅助检查结果,分析漏诊、误诊的临床特点及原因。方法:回顾性分析本院产科胎盘早剥产妇145例临床资料,根据最终确诊结果分为确诊组、漏诊组及误诊组,分析产妇一般资料、胎盘早剥的高危因素、临床表现及辅助检查结果。结果:确诊组早剥分级为III级占比最高,漏诊组I级构成比最高,误诊组II级占比最高;与确诊组及漏诊组比较,误诊组外伤比率最高,妊娠期高血压疾病比例最低(P均<0.05),而确诊组与漏诊组无差异(P>0.05);3组间年龄≥35岁、分娩次数≥3次、胎膜早破及羊水过多比例无差异(P>0.05);确诊组及误诊组阴道流血及腹痛比率高于漏诊组(P<0.05),确诊组与误诊组无差异(P>0.05);确诊组子宫压痛及血性羊水比率高于漏诊组及误诊组(P均<0.05),漏诊组与误诊组无差异(P>0.05),3组间子宫收缩、胎心率减慢或消失的比率无差异(P>0.05);超声检查异常比率确诊组及误诊组均高于漏诊组(P<0.001),确诊组与误诊组无差异(P>0.05);3组胎心监护异常、血容量异常、凝血功能异常比率无差异(P>0.05)。结论:单纯依赖外伤、阴道流血、腹痛及超声检查结果诊断胎盘早剥易造成漏诊或误诊,子宫压痛可作为降低漏诊、误诊率的参考指标。Objective:To investigate clinical manifestations and auxiliary examination of women with placental abruption,and to analyze their clinical characteristics and causes of missed diagnosis and misdiagnosis.Methods:The data of 145 parturient with placental abruption were analyzed retrospectively and were divided into the group A(diagnosis correctly),group B(women with missed diagnosis),and group C(women with misdiagnosis)according to the final diagnosis results.The general information high-risk factors of placental abruption,clinical manifestations and auxiliary examination results of women in three groups were analyzed.Results:The proportion of the grade III of placental abruption of women in group A was the highest,the proportion of the grade I of placental abruption of women in group B was the highest,and the proportion of the grade II of placental abruption of women in group C was the highest.The proportion of trauma of women in group C was the highest,the proportion of hypertension during pregnancy was the lowest(P<0.05),but the proportions of trauma and hypertension had no significant difference between group A and C(P>0.05).There were no significant different in proportions of the women aged≥35 years old,premature rupture of membranes,and polyhydramnios,and number of deliveries≥3 times of women among the three groups(P>0.05).The rates of vaginal bleeding and abdominal pain of women in group B was significant lower than that of women in group A and C(P<0.05),but which had no difference between group A and C(P>0.05).The rates of uterine tenderness and bloody amniotic fluid of women in group A was significant higher than that of women in group B and C(P<0.05),but which had no difference between group B and C(P>0.05).There were no significant different in the rates of uterine contraction and fetal heart rate slowing down or disappearing among the three groups(P>0.05).The rate of abnormal ultrasonic examination of women in group B was significant higher than that of women in group A and C(P<0.001),but which had

关 键 词：胎盘早剥 误诊 漏诊 子宫压痛 

分 类 号：R714.2[医药卫生—妇产科学]