黑龙江医学
黑龍江醫學
흑룡강의학
HEILONGJIANG MEDICAL JOURNAL
2015年
6期
652-653,654
,共3页
不典型%胎盘早剥%漏诊%产前检查
不典型%胎盤早剝%漏診%產前檢查
불전형%태반조박%루진%산전검사
Atypia%Abruption placentae%Misdiagnosis%Prenatal examination
目的:分析不典型胎盘早剥的产前漏诊原因,以指导临床诊断。方法以2010-01~2014-01间我院收治的180例胎盘早剥患者为研究对象,对其行回顾性分析,按是否出现产前漏诊将其划分为漏诊组( n=48)和确诊组( n=132)。对比两组发病诱因、临床症状与体征、胎盘早剥面积、总出血量、胎盘附着位置,分析产前漏诊的原因。结果漏诊组存在明确诱因者较确诊组明显更少(P<0.05),且漏诊组诱因以引产及催产为主;漏诊组临床症状及体征表现为腹痛及阴道出血者占比明显低于确诊组(P<0.05),且漏诊组多表现为胎心监护异常;漏诊组胎盘早剥面积、总出血量均明显低于确诊组( P<0.05);漏诊组胎盘附着于子宫后壁者所占比例明显高于确诊组( P<0.05)。结论不典型胎盘早剥多因引产及催产导致,临床症状及体征表现不明显,临床确诊需采取多种检测方案、结合病史,进行鉴别诊断。
目的:分析不典型胎盤早剝的產前漏診原因,以指導臨床診斷。方法以2010-01~2014-01間我院收治的180例胎盤早剝患者為研究對象,對其行迴顧性分析,按是否齣現產前漏診將其劃分為漏診組( n=48)和確診組( n=132)。對比兩組髮病誘因、臨床癥狀與體徵、胎盤早剝麵積、總齣血量、胎盤附著位置,分析產前漏診的原因。結果漏診組存在明確誘因者較確診組明顯更少(P<0.05),且漏診組誘因以引產及催產為主;漏診組臨床癥狀及體徵錶現為腹痛及陰道齣血者佔比明顯低于確診組(P<0.05),且漏診組多錶現為胎心鑑護異常;漏診組胎盤早剝麵積、總齣血量均明顯低于確診組( P<0.05);漏診組胎盤附著于子宮後壁者所佔比例明顯高于確診組( P<0.05)。結論不典型胎盤早剝多因引產及催產導緻,臨床癥狀及體徵錶現不明顯,臨床確診需採取多種檢測方案、結閤病史,進行鑒彆診斷。
목적:분석불전형태반조박적산전루진원인,이지도림상진단。방법이2010-01~2014-01간아원수치적180례태반조박환자위연구대상,대기행회고성분석,안시부출현산전루진장기화분위루진조( n=48)화학진조( n=132)。대비량조발병유인、림상증상여체정、태반조박면적、총출혈량、태반부착위치,분석산전루진적원인。결과루진조존재명학유인자교학진조명현경소(P<0.05),차루진조유인이인산급최산위주;루진조림상증상급체정표현위복통급음도출혈자점비명현저우학진조(P<0.05),차루진조다표현위태심감호이상;루진조태반조박면적、총출혈량균명현저우학진조( P<0.05);루진조태반부착우자궁후벽자소점비례명현고우학진조( P<0.05)。결론불전형태반조박다인인산급최산도치,림상증상급체정표현불명현,림상학진수채취다충검측방안、결합병사,진행감별진단。
Objective To analyze the causes of prenatal misdiagnosis of atypical abruption placentae , in order to guide clinical diagno-sis.Methods 180abruptionplacentaepatientsacceptedbythehospitalfromJanuary,2010toJanuary,2014wereselectedasthere-search object , and retrospective analysis was done .According to the diagnosis results , they were divided into Misdiagnosis Group ( n=48 ) and Diagnosis Group ( n=132 ) .The predisposing factors , clinical symptoms and signs , placental abruption area , the total amount of bleeding and placental location of two groups were compared .Results Patients with predisposing factors in Misdiagnosis Group was signifi-cantly less than in Diagnosis Group (P<0.05).And the main predisposing factors in Misdiagnosis Group were odinopoeia and hasten par-turition.Patients with clinical symptoms and signs , such as abdominal pain and vaginal bleeding in Misdiagnosis Group was significantly less than in Diagnosis Group (P<0.05).And the main clinical symptoms and signs in Misdiagnosis Group was fetal heart monitoring ab -normal.The placental abruption area and the total amount of bleeding in Group Misdiagnosis were significantly lower than that of Diagnosis Group (P<0.05).Patients whose placenta were attached to the posterior wall of the uterus were significantly more than in Diagnosis Group (P<0.05).Conclusion The causes of atypical abruption placentae are mainly due to odinopoeia and hasten parturition .Most patients′clinical symptoms and signs are not obvious .During clinical diagnosis , various detection schemes should be adopted , and the history be combined, in order to make right diagnosis.