CAJ | 학술논문

目的：探讨羊水胎粪污染程度和持续时间与胎盘病理改变的关系。方法回顾性分析356例羊水胎粪污染产妇的胎盘病理结果,观察Ⅰ度、Ⅱ度和Ⅲ度羊水污染后胎盘病变发生率,对比长时间和短时间粪染组胎盘病变发生率和病变类型之间的差异。结果Ⅰ度、Ⅱ度、Ⅲ度羊水污染组的胎盘病变发生率分别为38.2%,49.5%和72.0%,三组间存在显著差异(P＜0.01)。长时间粪染组胎盘病变发生率显著高于短时间粪染组,长时间粪染组的绒毛膜羊膜炎发生率显著低于短时间粪染组,但绒毛间质纤维化、合体滋养细胞增生的发生率显著高于短时间粪染组,差异具有统计学意义(P＜0.05)。结论羊水粪染程度和持续时间与胎盘病变发生率呈正相关,短时间粪染胎盘病变类型以急性炎性渗出为主,长时间粪染组以慢性炎症和绒毛间质纤维化、合体滋养细胞增生为主。
목적：탐토양수태분오염정도화지속시간여태반병리개변적관계。방법회고성분석356례양수태분오염산부적태반병리결과,관찰Ⅰ도、Ⅱ도화Ⅲ도양수오염후태반병변발생솔,대비장시간화단시간분염조태반병변발생솔화병변류형지간적차이。결과Ⅰ도、Ⅱ도、Ⅲ도양수오염조적태반병변발생솔분별위38.2%,49.5%화72.0%,삼조간존재현저차이(P＜0.01)。장시간분염조태반병변발생솔현저고우단시간분염조,장시간분염조적융모막양막염발생솔현저저우단시간분염조,단융모간질섬유화、합체자양세포증생적발생솔현저고우단시간분염조,차이구유통계학의의(P＜0.05)。결론양수분염정도화지속시간여태반병변발생솔정정상관,단시간분염태반병변류형이급성염성삼출위주,장시간분염조이만성염증화융모간질섬유화、합체자양세포증생위주。
Objective To investigate the relationship between the degree and duration of meconium-stained amniotic fluid (MSAF) and pathological changes of the placenta. Methods The pathological findings of 356 pregnant woman with MSAF were retrospectively analyzed, and the incidence of placenta pathological changes in different degree of MSAF (including degreeⅠ,Ⅱ,Ⅲ) was observed, the difference of pathological changes rate and type was compared in the long duration and short duration MSAF group. Results The incidence of placenta pathological changes in degreeⅠ, Ⅱ and Ⅲ MSAF groups were 38.2%, 49.5% and 72.0% respectively, the difference was statistical (P<0.01). The incidence of placenta pathological changes in long duration MSAF group was significantly higher than that in short duration MSAF group, the incidence of chorioamnionitis in long duration MSAF group was significantly lower than that in short duration MSAF group, the incidence of villus interstitial fibrosis and syncytiotrophoblast proliferation were significantly higher than that in short duration MSAF group, all the difference was statistical (P<0.05). Conclusions The degree and duration of MSAF have positive correlation with pathological changes of the placenta. The most common type of pathological changes in short duration MSAF is acute inflammatory exudation, and the common type of pathological changes in long duration MSAF are chronic inflammation, villus interstitial fibrosis and syncytiotrophoblast proliferation.