摘要
目的分析胎盘早剥严重程度与处理时限对母婴妊娠结局的影响,为提高临床早期识别能力、早期实施干预提供科学参考。方法回顾性分析2014年1月-2017年2月该院收治的胎盘早剥患者48例,采集患者临床资料,根据中华医学会妇产科学分会制定的《胎盘早剥的临床诊断与处理规范(第一版)》分为轻度早剥组(35例)和重度早剥组(13例),分析胎盘早剥严重程度不同与处理时限对母婴妊娠结局的影响。结果两组患者在发病诱因方面比较,差异无统计学意义(P>0.05);首发临床症状方面:重度早剥组腹痛、胎心异常、阴道流血症状与轻度早剥组比较,差异有统计学意义(P<0.05);两组腰背痛、子宫张力过高、血性羊水等症状方面比较,差异无统计学意义(P>0.05);轻度早剥组彩超检出率为65.71%(23/35),重度早剥组彩超检出率为92.30%(12/13),差异有统计学意义(P<0.05);轻度早剥组首发临床症状至处理时限为(487.5±51.9)min,重度早剥组首发临床症状至处理时限为(122.9±31.7)min,差异有统计学意义(P<0.05);不良结局与早剥严重程度及处理时限的关系:重度早剥组妊娠不良结局发生率明显高于轻度早剥组(84.61%vs.51.43%),差异有统计学意义(χ~2=4.365,P<0.05);发生产后出血、弥散性血管内凝血(DIC)、胎盘卒中及新生儿死亡、窒息、死胎患者胎盘早剥处理时限明显长于无不良结局患者(P<0.05)。结论母婴妊娠结局与胎盘早剥严重程度及处理时限有关,早期有效的处理对于改善妊娠结局具有重要意义。
Objective To analyze the effects of severity of placental abruption and treatment time on maternal and infant outcomes,provide a scientific reference for improving early diagnostic capability and conducting early intervention. Methods Forty-eight patients with placental abruption treated in Guangyuan Municipal Central Hospital from January 2014 to February 2017 were selected,the clinical data was collected,and the patients were divided into mild placental abruption group（ 35 cases） and severe placental abruption group（ 13 cases） according to clinical diagnosis and treatment norm of placental abruption（ the First edition） developed by obstetrics and gynecology branch of Chinese Medical Association. The effects of severity of placental abruption and treatment time on maternal and infant outcomes were analyzed. Results There was no statistically significant difference in predisposing factors between the two groups（ P〈0. 05）. There were statistically significant differences in abdominal pain,abnormal fetal heart rate,and vaginal bleeding symptoms between mild placental abruption group and severe placental abruption group（ P〈0. 05）. There was no statistically significant difference in low back pain,high uterine tension,and bloody amniotic fluid between mild placental abruption group and severe placental abruption group（ P〈0. 05）. The detection rates of color ultrasonography in mild placental abruption group and severe placental abruption group were 65. 71%（ 23/35） and 92. 30%（ 12/13）,respectively,there was statistically significant difference between the two groups（ P〈0. 05）. The treatment time in mild placental abruption group was（ 487. 5±51. 9） minutes,and the treatment time in severe placental abruption group was（ 122. 9 ±31. 7） minutes,there was statistically significant difference between the two groups（ P〈0. 05）. The incidence rate of adverse reactions in severe placental abruption group was 84. 61%,which was statistically significantly higher than that
出处
《中国妇幼保健》
CAS
2018年第6期1260-1263,共4页
Maternal and Child Health Care of China
关键词
胎盘早剥
处理时限
妊娠结局
相关性
Placental abruption
Treatment time
Pregnancy outcome
Correlation
