摘要
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14333例，胎盘早剥发生率为1．3％（180／14333），其中子宫胎盘卒中发生率0．4％（58／14333），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。
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.
出处
《中国综合临床》
2013年第7期781-784,共4页
Clinical Medicine of China
关键词
胎盘早剥
子宫胎盘卒中
危险因素
妊娠结局
Abruption placenta
Uteroplacental apoplexy
Risk factors
Pregnacy outcome
