摘要
目的 探讨超声结合临床特征评分量表在前置胎盘术前评估及处理中的应用价值。方法 选取2019年1月至2020年6月喀什地区第二人民医院,喀什地区泽普、莎车、叶城、巴楚县人民医院分娩的137例前置胎盘患者的临床资料进行研究和分析。根据超声结合临床特征的评分量表,确定预测产后出血及子宫切除的临界分值。按评分将患者分为A组(<5分)、B组(5~8分)、C组(≥9分),对各组的年龄、体质量指数(BMI)、妊娠次数、剖宫产次数、出血量、输血量、住院天数、母儿并发症等情况进行分析。结果 5分、6分、9分是预测产后出血、严重产后出血(出血量≥2000 mL)和子宫切除的临界值。超声结合临床特征评分值与出血量呈正相关(r=0.737,P<0.05)。三组年龄、怀孕次数、剖宫产次数、前置胎盘类型比较,差异有统计学意义(P<0.05),而BMI、分娩孕龄、超声胎盘厚度等比较,差异无统计学意义(P>0.05);在出血量、输血量、子宫切除数及手术时间上C组(≥9分)最高(P<0.05),急诊手术率比较,差异无统计学意义(P>0.05)。三组在住院时间、术后住院时间和入ICU时间上C组(≥9分)最高(P<0.05),新生儿Apgar评分比较,差异无统计学意义(P>0.05)。结论 术前进行超声结合临床特征评分能有效预测产后出血、子宫切除等风险,5分是预测产后出血的临界值,9分是预测子宫切除的临界值。新的评分量表能够预测前置胎盘的出血风险,对于减少产后出血相关并发症,改善妊娠结局有重要作用。
Objective To investigate the value of ultrasonography combined with clinical feature scoring scale in preoperative evaluation and treatment of placenta previa.Methods The clinical data of 137 patients with placenta previa delivered in Kashgar Second People′s Hospital,Zepu,Shache,Yecheng and Bachu County People′s Hospital of Kashgar from January 2019 to June 2020 were selected for study and analysis.The cut-off score for the prediction of postpartum hemorrhage and hysterectomy was determined based on ultrasonography combined with clinical feature scoring scale.The patients were divided into group A(<5 points),group B(5-8 points),and group C(≥9 points)according to the score.The age,body mass index(BMI),number of pregnancies,number of cesarean sections,blood loss,blood transfu-sion volume,length of hospital stay,and maternal and fetal complications in each group were analyzed.Results The cut-off value for predicting postpartum hemorrhage,severe postpartum hemorrhage(bleeding volume≥2000 mL),and hysterectomy was 5,6,and 9 points,respectively.There was a positive correlation between ultrasound combined with clinical feature score values and blood loss(r=0.737,P<0.05).There were differences in age,number of pregnancies,number of cesarean sections,and type of placenta previa among the three groups(P<0.05).While there was no significant difference in BMI,delivery,and placental thickness(P>0.05);group C(≥9 points)had the highest points in blood loss,blood transfusion volume,number of hysterectomies,and operation time(P<0.05).There was no difference in the rate of emergency surgery(P>0.05).The three groups had the highest hospital stay,postoperative hospital stay,and ICU admission time in group C(≥9 points)(P<0.05),while there was no difference in neonatal Apgar score(P>0.05).Conclusion Preoperative ultrasound combined with clinical feature scoring scale can effectively predict the risk of postpartum hemorrhage and hysterectomy.The cut-off value for predicting postpartum hemorrhage is five points,and the cut-of
作者
周贇
努尔古丽·玉苏云
熊瑛
孙俐红
万玲
米热姑丽·沙吾尔
哈斯也提·依达也提
吾斯尼阿依·艾合麦提
ZHOU Yun;NUERGULI·Yusuyun;XIONG Ying;SUN Lihong;WAN Ling;MIREGULI·Shawuer;HASIYETI·Yidayeti;WUSINIAYI·Aihemaiti(Department of Obstetrics and Gynecology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai200092,China;Department of Obstetrics,Kashgar Prefecture Second People′s Hospital in Xinjiang Uygur Autonomous Region,Kashi844000,China;Department of Nursing,Kashgar Prefecture Second People′s Hospital in Xinjiang Uygur Autonomous Region,Kashi844000,China;Department of Obstetrics and Gynecology,Bachu County People′s Hospital in Xinjiang Uygur Autonomous Region,Bachu843800,China;Department of Obstetrics,Yecheng County People′s Hospital in Xinjiang Uygur Autonomous Region,Yecheng844900,China;Department of Obstetrics and Gynecology in Xinjiang Uygur Autonomous Region,Zepu County People′s Hospital,Zepu844800,China;Department of Obstetrics and Gynecology,Shache County People′s Hospital in Xinjiang Uygur Autonomous Region,Shache844700,China)
出处
《中国现代医生》
2021年第26期82-86,共5页
China Modern Doctor
基金
上海市科学技术委员会科技计划项目(20035801000)。
关键词
前置胎盘
产后出血
超声结合临床特征评分量表
临界值
Placenta previa
Postpartum hemorrhage
Ultrasound combined with clinical feature scoring scale
Cut-off value
