中国妇幼健康研究
中國婦幼健康研究
중국부유건강연구
CHINESE JOURNAL OF MATERNAL AND CHILD HEALTH RESEARCH
2014年
5期
799-801
,共3页
凶险型前置胎盘%新生儿%产后出血%子宫切除%早产
兇險型前置胎盤%新生兒%產後齣血%子宮切除%早產
흉험형전치태반%신생인%산후출혈%자궁절제%조산
pernicious placenta previa%neonates%postpartum hemorrhage%hysterectomia%premature
目的：探讨凶险型前置胎盘产妇的妊娠结局及对围生儿的影响。方法回顾性分析282例前置胎盘产妇的临床资料，根据有无剖宫产史分为凶险型前置胎盘46例和非凶险型前置胎盘236例，比较分析两组间剖宫产、产后出血、胎盘粘连、胎盘植入、子宫切除等发生率，以及两组间早产、新生儿出生体重、Apgar评分、新生儿死亡等指标的差异。结果①凶险型组产妇产后出血、胎盘植入、子宫切除的发生率均显著高于非凶险型组（χ2值分别为42．336、58．509、27．957，均P＜0．01），而两组间剖宫产和胎盘粘连的发生率差异无统计学意义（χ2值分别为3．088、3．864，均P＞0．05）；②凶险型组新生儿早产发生率显著高于非凶险型组（χ2＝31．090，P＜0．01），新生儿出生体重显著低于非凶险型组（t＝13．368，P＜0．01），而两组间新生儿出生1分钟、5分钟Apgar评分比较无统计学差异（ t 值分别为1．970、1．493，均P＞0．05）、新生儿死亡率比较差异无统计学意义（χ2＝0．693，P＞0．05）。结论凶险型组产后出血、胎盘植入、子宫切除及早产的发生率显著高于非凶险型组，医生应注重对有剖宫产史孕妇的孕期管理及病情评估，并适时进行预防性处置是改善母儿妊娠结局的有效手段。
目的：探討兇險型前置胎盤產婦的妊娠結跼及對圍生兒的影響。方法迴顧性分析282例前置胎盤產婦的臨床資料，根據有無剖宮產史分為兇險型前置胎盤46例和非兇險型前置胎盤236例，比較分析兩組間剖宮產、產後齣血、胎盤粘連、胎盤植入、子宮切除等髮生率，以及兩組間早產、新生兒齣生體重、Apgar評分、新生兒死亡等指標的差異。結果①兇險型組產婦產後齣血、胎盤植入、子宮切除的髮生率均顯著高于非兇險型組（χ2值分彆為42．336、58．509、27．957，均P＜0．01），而兩組間剖宮產和胎盤粘連的髮生率差異無統計學意義（χ2值分彆為3．088、3．864，均P＞0．05）；②兇險型組新生兒早產髮生率顯著高于非兇險型組（χ2＝31．090，P＜0．01），新生兒齣生體重顯著低于非兇險型組（t＝13．368，P＜0．01），而兩組間新生兒齣生1分鐘、5分鐘Apgar評分比較無統計學差異（ t 值分彆為1．970、1．493，均P＞0．05）、新生兒死亡率比較差異無統計學意義（χ2＝0．693，P＞0．05）。結論兇險型組產後齣血、胎盤植入、子宮切除及早產的髮生率顯著高于非兇險型組，醫生應註重對有剖宮產史孕婦的孕期管理及病情評估，併適時進行預防性處置是改善母兒妊娠結跼的有效手段。
목적：탐토흉험형전치태반산부적임신결국급대위생인적영향。방법회고성분석282례전치태반산부적림상자료，근거유무부궁산사분위흉험형전치태반46례화비흉험형전치태반236례，비교분석량조간부궁산、산후출혈、태반점련、태반식입、자궁절제등발생솔，이급량조간조산、신생인출생체중、Apgar평분、신생인사망등지표적차이。결과①흉험형조산부산후출혈、태반식입、자궁절제적발생솔균현저고우비흉험형조（χ2치분별위42．336、58．509、27．957，균P＜0．01），이량조간부궁산화태반점련적발생솔차이무통계학의의（χ2치분별위3．088、3．864，균P＞0．05）；②흉험형조신생인조산발생솔현저고우비흉험형조（χ2＝31．090，P＜0．01），신생인출생체중현저저우비흉험형조（t＝13．368，P＜0．01），이량조간신생인출생1분종、5분종Apgar평분비교무통계학차이（ t 치분별위1．970、1．493，균P＞0．05）、신생인사망솔비교차이무통계학의의（χ2＝0．693，P＞0．05）。결론흉험형조산후출혈、태반식입、자궁절제급조산적발생솔현저고우비흉험형조，의생응주중대유부궁산사잉부적잉기관리급병정평고，병괄시진행예방성처치시개선모인임신결국적유효수단。
Objective To explore the pregnancy outcomes of patients with pernicious placenta previa and the perinatal influence.Methods A retrospective analysis was conducted on clinical data of 282 puerperas with placenta previa.They were divided into pernicious placenta previa group (46 cases) and non-pernicious placenta previa group (236 cases) according to the history of cesarean section and placental location.The incidences of cesarean section, postpartum hemorrhage, placenta adherence, placenta implantation and uterine excision were compared between two groups, and the differences in premature birth, neonatal weight, Apgar scores and neonatal death between two groups were analyzed.Results The incidence rates of postpartum hemorrhage, placenta implantation and hysterectomy in pernicious previa group were significantly higher than those of non-pernicious placenta previa group (χ2 value was 42.336, 58.509 and 27.957, respectively, all P<0.01), but there were no significant differences in the rates of cesarean section and placenta adhesion (χ2 value was 3.088 and 3.864, respectively, both P>0.05).The rate of neonatal premature in pernicious previa group was significantly higher than that of non-pernicious placenta previa group (χ2 =31.090, P<0.01), and the newborn birth weight was significantly lower than that of non-pernicious placenta previa group ( t=13.368, P<0.01) .However, there was no significant difference in Apgar scores after born for 1 min and 5 mins (t value was 1.970 and 1.493, respectively, both P>0.05).The two groups had no significant difference in neonatal mortality rate (χ2 =0.693,P>0.05).Conclusion The incidence rates of postpartum hemorrhage, placenta accreta, hysterectomy and premature delivery are significantly higher in pernicious placenta previa group than in non-pernicious placenta previa group.Attentions should be paid to pregnancy inspections and disease evaluation on patients with history of cesarean section.Timely preventive treatment is a necessary means to improve maternal and neonatal outcomes.
