中国临床新医学
中國臨床新醫學
중국림상신의학
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
2014年
1期
58-61
,共4页
前置胎盘%胎盘植入%高危因素%超声诊断%治疗方法
前置胎盤%胎盤植入%高危因素%超聲診斷%治療方法
전치태반%태반식입%고위인소%초성진단%치료방법
Placenta previa%Placenta accreta%High risk factors%Ultrasonic diagnosis%Treatment
目的：探讨前置胎盘合并胎盘植入的高危因素、诊断及治疗方法。方法对82例前置胎盘（前置胎盘组）和前置胎盘合并胎盘植入12例（胎盘植入组）孕产妇的临床资料进行回顾性分析。结果孕妇的年龄、孕次、前置胎盘类型及子宫手术史是发生胎盘植入的高危因素；胎盘植入组早产、新生儿窒息和产后出血的发生率均高于前置胎盘组（ P＜0.05）；产前彩色多普勒超声诊断前置胎盘合并胎盘植入的正确率为83.3％（10/12），胎盘增厚、胎盘后方子宫壁肌层低回声带变薄（≤1 mm）或消失、胎盘实质内血流丰富、胎盘内腔隙是诊断前置胎盘合并胎盘植入的特征性声像图；治疗方法主要是积极的期待疗法及适时终止妊娠。结论孕妇年龄≥30岁、孕次≥3次、中央型前置胎盘及子宫手术史是前置胎盘合并胎盘植入的高危因素，彩色多普勒超声产前诊断胎盘植入是目前最简便可行的方法，采取个体化处理措施可改善母婴结局。
目的：探討前置胎盤閤併胎盤植入的高危因素、診斷及治療方法。方法對82例前置胎盤（前置胎盤組）和前置胎盤閤併胎盤植入12例（胎盤植入組）孕產婦的臨床資料進行迴顧性分析。結果孕婦的年齡、孕次、前置胎盤類型及子宮手術史是髮生胎盤植入的高危因素；胎盤植入組早產、新生兒窒息和產後齣血的髮生率均高于前置胎盤組（ P＜0.05）；產前綵色多普勒超聲診斷前置胎盤閤併胎盤植入的正確率為83.3％（10/12），胎盤增厚、胎盤後方子宮壁肌層低迴聲帶變薄（≤1 mm）或消失、胎盤實質內血流豐富、胎盤內腔隙是診斷前置胎盤閤併胎盤植入的特徵性聲像圖；治療方法主要是積極的期待療法及適時終止妊娠。結論孕婦年齡≥30歲、孕次≥3次、中央型前置胎盤及子宮手術史是前置胎盤閤併胎盤植入的高危因素，綵色多普勒超聲產前診斷胎盤植入是目前最簡便可行的方法，採取箇體化處理措施可改善母嬰結跼。
목적：탐토전치태반합병태반식입적고위인소、진단급치료방법。방법대82례전치태반（전치태반조）화전치태반합병태반식입12례（태반식입조）잉산부적림상자료진행회고성분석。결과잉부적년령、잉차、전치태반류형급자궁수술사시발생태반식입적고위인소；태반식입조조산、신생인질식화산후출혈적발생솔균고우전치태반조（ P＜0.05）；산전채색다보륵초성진단전치태반합병태반식입적정학솔위83.3％（10/12），태반증후、태반후방자궁벽기층저회성대변박（≤1 mm）혹소실、태반실질내혈류봉부、태반내강극시진단전치태반합병태반식입적특정성성상도；치료방법주요시적겁적기대요법급괄시종지임신。결론잉부년령≥30세、잉차≥3차、중앙형전치태반급자궁수술사시전치태반합병태반식입적고위인소，채색다보륵초성산전진단태반식입시목전최간편가행적방법，채취개체화처리조시가개선모영결국。
Objective To investigate the high risk factors,diagnosis and management of placenta previa combined with placenta accreta .Methods The clinical data of 12 cases of placenta previa combined with placenta accrete ( placenta accreta group ) and 82 cases of placenta previa ( placenta previa group ) were analyzed retrospective-ly.Results The age, gravidity, the types of placenta previa and uterine operation history were high risk factors of placenta accreta;The incidences of premature delivery , neonatal asphyxia and postpartum hemorrhage of placenta ac-creta group were higher than those of placenta previa group ( all P<0.05 );The accuracy rate of prenatal color doppler ultrasound in the diagnosis of placenta previa with accreta was 83.3%(10/12).Placenta thickening, the hypoecho of uterine wall muscle layer at the rear of placenta band of being thinning (≤1 mm) or disappeaing , placental parenchy-ma′s rich blood flow , placental cavity gap were characteristic sonogram of placenta previa combined with placenta ac -creta;Expectant treatment and timely termination of pregnancy were the main treatment methods .Conclusion Over 30 years of age ,pregnancy over three times , central type of placenta previa and uterine operation history are high risk factors.Color Doppler ultrasound is currently the most convenient method in diagnosis of placenta accreta .The indi-vidual treatment can improve maternal and neonatal outcomes .
