中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
7期
781-784
,共4页
胎盘早剥%子宫胎盘卒中%危险因素%妊娠结局
胎盤早剝%子宮胎盤卒中%危險因素%妊娠結跼
태반조박%자궁태반졸중%위험인소%임신결국
Abruption placenta%Uteroplacental apoplexy%Risk factors%Pregnacy outcome
目的 探讨胎盘早剥以及并发子宫胎盘卒中的危险因素及母婴结局,以提高早期诊断率,降低母婴并发症的发生率.方法 回顾性分析天津市第一中心医院2007年1月至2011年12月180例胎盘早剥并发58例子宫胎盘卒中患者的临床资料.胎盘早剥并发子宫胎盘卒中58例作为观察组,其余122例作为对照组,比较两组的发病危险因素、临床特点以及母婴结局.结果 5年来共分娩14 333例,胎盘早剥发生率为1.3％(180/14 333),其中子宫胎盘卒中发生率0.4％(58/14 333),胎盘早剥患者中子宫胎盘卒中的发生率为32.2％(58/180).观察组发病持续时间(9.14±8.47)h、胎盘附着于子宫后壁比例(63.9％,23/36)明显高于对照组[(5.88±4.31)h、43.4％(36/83)],差异均有统计学意义(t值为3.426、x2值6.461,P＜0.01或P＜0.05).观察组58例患者产后出血、弥散性血管内凝血、急性肾功能衰竭及死胎死产发生率(12.1％、12.1％、13.8％、60.3％)高于对照组(共122例,2.5％、2.5％、0.8％、11.5％),差异均有统计学意义(x2值分别为6.919、6.919、13.929、47.388,P＜0.05或P＜0.01).结论 胎盘早剥以及并发子宫胎盘卒中的危险因素为发病持续时间长、胎盘附着于子宫后壁.胎盘早剥并发子宫胎盘卒中的妊娠结局不良.
目的 探討胎盤早剝以及併髮子宮胎盤卒中的危險因素及母嬰結跼,以提高早期診斷率,降低母嬰併髮癥的髮生率.方法 迴顧性分析天津市第一中心醫院2007年1月至2011年12月180例胎盤早剝併髮58例子宮胎盤卒中患者的臨床資料.胎盤早剝併髮子宮胎盤卒中58例作為觀察組,其餘122例作為對照組,比較兩組的髮病危險因素、臨床特點以及母嬰結跼.結果 5年來共分娩14 333例,胎盤早剝髮生率為1.3％(180/14 333),其中子宮胎盤卒中髮生率0.4％(58/14 333),胎盤早剝患者中子宮胎盤卒中的髮生率為32.2％(58/180).觀察組髮病持續時間(9.14±8.47)h、胎盤附著于子宮後壁比例(63.9％,23/36)明顯高于對照組[(5.88±4.31)h、43.4％(36/83)],差異均有統計學意義(t值為3.426、x2值6.461,P＜0.01或P＜0.05).觀察組58例患者產後齣血、瀰散性血管內凝血、急性腎功能衰竭及死胎死產髮生率(12.1％、12.1％、13.8％、60.3％)高于對照組(共122例,2.5％、2.5％、0.8％、11.5％),差異均有統計學意義(x2值分彆為6.919、6.919、13.929、47.388,P＜0.05或P＜0.01).結論 胎盤早剝以及併髮子宮胎盤卒中的危險因素為髮病持續時間長、胎盤附著于子宮後壁.胎盤早剝併髮子宮胎盤卒中的妊娠結跼不良.
목적 탐토태반조박이급병발자궁태반졸중적위험인소급모영결국,이제고조기진단솔,강저모영병발증적발생솔.방법 회고성분석천진시제일중심의원2007년1월지2011년12월180례태반조박병발58례자궁태반졸중환자적림상자료.태반조박병발자궁태반졸중58례작위관찰조,기여122례작위대조조,비교량조적발병위험인소、림상특점이급모영결국.결과 5년래공분면14 333례,태반조박발생솔위1.3％(180/14 333),기중자궁태반졸중발생솔0.4％(58/14 333),태반조박환자중자궁태반졸중적발생솔위32.2％(58/180).관찰조발병지속시간(9.14±8.47)h、태반부착우자궁후벽비례(63.9％,23/36)명현고우대조조[(5.88±4.31)h、43.4％(36/83)],차이균유통계학의의(t치위3.426、x2치6.461,P＜0.01혹P＜0.05).관찰조58례환자산후출혈、미산성혈관내응혈、급성신공능쇠갈급사태사산발생솔(12.1％、12.1％、13.8％、60.3％)고우대조조(공122례,2.5％、2.5％、0.8％、11.5％),차이균유통계학의의(x2치분별위6.919、6.919、13.929、47.388,P＜0.05혹P＜0.01).결론 태반조박이급병발자궁태반졸중적위험인소위발병지속시간장、태반부착우자궁후벽.태반조박병발자궁태반졸중적임신결국불량.
Objective To investigate the risk factors and outcomes of uteroplacental apoplexy complicating severe placental abruption in order to enhance the accuracy of early diagnosis and decrease the complication of mother and fetus.Methods A retrospective study of clinical data was conducted in 180 cases of placental abruption complicating uteroplacental apoplexy in 58 cases who delivered in the First Central Hospital of Tianjin from January 2007 to December 2011.Risk factors,clinical characteristics and outcomes were compared between the 58 cases complicating uteroplacental apoplexy (experimental group) and the other 122 cases without complicating uteroplacental apoplexy (control group).Results The incidence of placental abruption was 1.3％ (180/14 333),with the rate of uteroplacental apoplexy complicating placental abruption was 0.4％ (58/14 333) of all deliveries and 32.2％ (58/180) of all abruption cases.The duration of disease was significantly longer and the rate of placenta implanted on the posterior wall of uterus was significantly higher in the experimental group (9.14 ± 8.47) h; 63.9％ (23/36)) than in control group (5.88 ±4.31) h; 43.4％ (36/83)) (t =3.426,x2 =6.461 ; P ＜ 0.05).There were significant differences between the experimental group (12.1％,12.1％,13.8％ and 60.3 ％) and the control group (2.5 ％,2.5 ％,0.8％ and 11.5 ％) in postpartum hemorrhage,DIC,acute renal failure and stillbirth (x2 =6.919,6.919,13.929 and 47.388 respectively,P ＜ 0.05 or P ＜ 0.01).Conclusion Long duration of disease and posterior-wall placenta are risk factors for uteroplacental apoplexy complicating placental abruption which may lead to a poor maternal-fetal prognosis.
