CAJ | 학술논문

目的总结胎盘部位超常反应(EPS)的临床和病理特点,探讨其发病规律及诊治策略.方法对34例EPS患者的临床资料进行回顾性分析.结果 34例患者中,足月剖宫产11例,正常分娩2例,自然或人工流产21例；有妊娠史31例；行子宫切除术15例,刮宫术13例,宫腔镜探查病灶电切术6例,经治疗后全部患者均痊愈.结论 EPS无法在产前、产时诊断,均依靠病理确诊.在分娩或流产后出血经常规处理效果不佳时,应考虑存在EPS的可能.如出血多,及时切除子宫是其有效的治疗手段,可以挽救患者生命；如出血不多,可行刮宫或宫腔镜探查术处理病灶,治疗效果显著,可有效避免子宫切除.
목적 총결태반부위초상반응(EPS)적림상화병리특점,탐토기발병규률급진치책략.방법 대34례EPS환자적림상자료진행회고성분석.결과 34례환자중,족월부궁산11례,정상분면2례,자연혹인공유산21례；유임신사31례；행자궁절제술15례,괄궁술13례,궁강경탐사병조전절술6례,경치료후전부환자균전유.결론 EPS무법재산전、산시진단,균의고병리학진.재분면혹유산후출혈경상규처리효과불가시,응고필존재EPS적가능.여출혈다,급시절제자궁시기유효적치료수단,가이만구환자생명；여출혈불다,가행괄궁혹궁강경탐사술처리병조,치료효과현저,가유효피면자궁절제.
Objective To summarize the clinical and pathological features of exaggerated placental site (EPS),explore its pathogenesis regularity,diagnosis and treatment strategies.Methods The clinical data related to 34 patients with EPS were analyzed retrospectively.Results In 34 patients,11 patients performed full-term cesarean section,2 patients performed normal vaginal delivery,the other 21 patients had abortion.Thirty-one patients had pregnancy history.Fifteen patients performed hysterectomy,13 patients performed dilatation and curettage,6 patients performed exploratory hysteroscopy and lesions resection.All the patients survived after treatment.Conclusions The patients can not be diagnosed in the antepartum and intrapartum,but can be diagnosed relying on the pathological diagnosis.When it is ineffective to stop bleeding after delivery or abortion by conventional treatment,we should consider the possibility of EPS.Timely perform hysterectomy is theeffective method to stop bleeding,can save the life of patients.If bleeding is not much,curettage or exploratory hysteroscopy can get a significant effective treatment and avoid hysterectomy.