不同面积胎盘剥离患者妊娠结局比较及意义  

Comparison the pregnancy outcomes between patients with different placenta abruption area and its meaning

作　　者：张丽丽 Zhang Lili(Department of Gynecology and Obstetrics in North District of SuZhou Hospital Affiliated NanJing Medical University,SuZhou JiangSu,215000,China)

机构地区：[1]南京医科大学附属苏州市立医院(北区)妇产科,江苏苏州215000

出　　处：《中外女性健康研究》2022年第13期32-34,共3页Women＇s Health Research

摘　　要：目的:通过对胎盘早剥患者临床资料进行分析,以发现一定的规律为临床提供参考。方法:随机收集本院资料完整的91例胎盘早剥患者,依据产后胎盘剥离面积分为:Ⅰ组61例胎盘剥离面积<30%,Ⅱ组17例胎盘剥离面积为30%~50%,Ⅲ组13例胎盘剥离面积>50%。对常见合并症、临床表现和妊娠结局进行统计分析。结果:1)妊娠期高血压在第Ⅲ组构成比为23.0%,而在第Ⅰ组和第Ⅱ组构成比分别为2.0%和6.0%。胎膜早破患者在第Ⅰ组和第Ⅱ组的构成比分别为20.0%、35.0%,而第Ⅲ组中仅占8.0%。2)阴道出血三组所占比为41.0%、41.0%、46.0%,血性羊水为71.0%、71.0%、77.0%,胎心异常分别为(14例、23.0%),(4例、24.0%),(6例、46.0%)。3)剖宫产为Ⅰ组(43例、70.0%),Ⅱ组(16例、94.0%),Ⅲ组(11例、85.0%);平产为(18例、30.0%),(1例、6.0%),(2例、15.0%);子宫胎盘卒中为(3例、5.0%),(0例、0.0%),(4例、31.0%);产后出血为(5例、8.0%),(2例、12.0%),(5例、39.0%);新生儿窒息为(2例、3.0%),(0例、0.0%),(4例、31.0%)。以各点制作折线图发现第Ⅱ组和第Ⅲ组折线趋势相似,而第Ⅰ组的折线变化比较明显且在剖宫产和血性羊水例数达峰值。对患者年龄、住院天数、分娩孕周、新生儿体质量、出血量及胎盘剥离面积进行比较,各组间均有明显差异,P<0.01。结论:1)传统以1/3为界点将胎盘早剥分为轻型和重型存在一定的合理性。2)合并妊娠高血压的患者容易发生面积>50%的胎盘剥离,而胎膜早破患者容易发生面积<50%的胎盘剥离。3)妊娠结局和胎盘剥离面积密切相关,剥离面积越大的患者不良结局更严重。因此,临床上可依据高危因素和主要临床表现严密监护,做出恰当的应急处理,以避免和减少不良结局。Objective:By analyzed the clinical data on placenta abruption patients,explore certain regular for clinical reference.Methods:Randomly collected 91 patients who suffered placenta abruption with intact clinical data in our hospital,three groups were classified by the area of placenta abruption:group Ⅰ contained 61 patients with the area of placenta abruption<30%,group Ⅱ included 17 patients with the area of placenta abruption 30%~50%,Ⅲ group accepted 13 patients with the area of placenta abruption>50%.And applied statistical analysis on complications、clinical manifestations and pregnancy outcomes.Results:Patients complicated Hypertensive disorders in pregnancy had a constitution of 23.0% in group Ⅲ,and the constitution were only 2.0% and 6.0% in group Ⅰ and group Ⅱ separately.The constitution of patients complicated premature rupture of membranes were 20.0% and 35.0% in group Ⅰ and group Ⅱ,but in group Ⅲ was only 8.0%.The constituent ratio of bleeding from vaginal in three groups were 41.0%、41.0%、46.0% separately,and the constitution of bloody amniotic fluid were 71.0%、71.0%、77.0%.The proportion of abnormal fetal heart beats were(14 cases、23.0%),(4 cases、24.0%),(6 cases、46.0%).As the pregnancy outcomes,the constitution of cesarean section were(43 cases、70.0%),(16 cases、94.0%),(11 cases、85.0%)in three group separately;and the vaginal labor were(18 cases、30.0%),(1 case、6.0%),(2 cases、15.0%);The Uteroplacental stroke were(3cases、5.0%),(0 case、0.0%),(4 cases、31.0%);Postpartum hemorrhage were(5 cases、8.0%),(2 cases、12.0%),(5 cases、39.0%);Neonatal asphyxia were(2 cases、3.0%),(0 case、0.0%),(4 cases、31.0%).When making a line chart according to each point and case value,we found that the trend of broken line on group Ⅱ manifested similarity to that of group Ⅲ,and accompanied by each other.The line trend of group Ⅰ performed apparent different and reached the peak at the point of cesarean section and bloody amniotic fluid cases.Compared age,length of hosp

关 键 词：胎盘早剥 妊娠期高血压 胎膜早破 子宫胎盘卒中 新生儿窒息 

分 类 号：R714.21[医药卫生—妇产科学]