CAJ | 학술논문

目的：分析胎盘早剥的误诊及漏诊原因，提高不典型胎盘早剥的早期诊断率，改善母儿预后。方法2009年1月—2014年1月该院收治分娩孕产妇产前未明确诊断而产后确诊的胎盘早剥病例32例，误诊为先兆早产或临产16例、前置胎盘8例、胎儿窘迫6例、先兆子宫破裂2例，对临床资料进行回顾性分析。结果胎盘早剥误诊及漏诊率66.7%。发病诱因主要有妊娠期高血压疾病、胎膜早破、脐带过短或绕颈及不明原因；临床症状不典型、B超检查的阳性率低，胎心监护改变无特异性是其误诊及漏诊的主要原因。结论临床上只有重视诱因和不典型的临床症状，动态胎心监护，结合B超及实验室检查，综合分析，提高不典型胎盘早剥的早期诊断率并及时处理，才能改善母儿预后。
목적：분석태반조박적오진급루진원인，제고불전형태반조박적조기진단솔，개선모인예후。방법2009년1월—2014년1월해원수치분면잉산부산전미명학진단이산후학진적태반조박병례32례，오진위선조조산혹임산16례、전치태반8례、태인군박6례、선조자궁파렬2례，대림상자료진행회고성분석。결과태반조박오진급루진솔66.7%。발병유인주요유임신기고혈압질병、태막조파、제대과단혹요경급불명원인；림상증상불전형、B초검사적양성솔저，태심감호개변무특이성시기오진급루진적주요원인。결론림상상지유중시유인화불전형적림상증상，동태태심감호，결합B초급실험실검사，종합분석，제고불전형태반조박적조기진단솔병급시처리，재능개선모인예후。
Objective Analysis of misdiagnosis and missed diagnosis of placental abruption , improve early diagnosis of atypical placental abruption and improve the prognosis of female children . Methods January 2009 to January 2014 our hospital before delivery Motherhood Maternity is not a clear diagnosis and postnatal diagnosis of placental abruption cases , 32 cases were misdiagnosed as threatened premature labor or labor 16 cases , 8 cases of placenta previa , fetal distress six cases , two cases of threatened uterine rupture , clinical data were retrospectively analyzed . Results Abruption misdiagnosis and missed diagnosis rate of 66.7%. Predisposing factors are mainly hypertensive disorders in pregnancy , premature rupture of membranes , umbilical cord is too short or around the neck and unexplained;atypical clinical symptoms , positive rate of B-ultrasound and fetal heart rate monitoring is no specific change its misdiagnosis and missed diagnosis the main reason. Conclusion Only the importance of incentives and clinically atypical clinical symptoms, dynamic fetal heart rate monitoring , combined B ultrasonography and laboratory examination , comprehensive analysis, improve early diagnosis of atypical placental abruption and timely manner , in order to improve the prognosis of female children .