【摘要】 目的探讨胎盘早剥的发病因素及不同类型胎盘早剥对母婴结局的影响。方法随机选取2013年7月—2016年6月在苏州市立医院母子保健中心产科分娩的胎盘早剥患者110例,根据患者的病情,分为轻度组、重度组,分析两组发病因素、母婴结局等。结果发病因素包括妊娠期高血压(25.45%),妊娠期肝内胆汁淤积(13.64%)、胎儿宫内生长受限(10.91%)、羊水过多(9.09%)、胎膜早破(21.82%),创伤劳累(6.36%);轻度组以胎膜早破为主,重度组以妊娠期高血压为主。患者临床症状包括腹痛(60.91%)、腰酸(8.18%)、阴道出血(72.73%)、血样羊水(38.18%)、自发早产(50.00%)、子宫板状硬伴压痛(17.27%);轻度与重度组分别以阴道出血、腹痛为主。轻度组阴道分娩占54.55%,显著高于重度组的9.09%(P<0.05)。产妇结局包括产后出血(32.73%),胎盘卒中(40.00%),DIC(10.00%),肾衰竭(5.45%),休克(4.54%);重度组中胎盘卒中和产后出血比例显著高于轻度组(P<0.05)。轻度组5.45%轻度窒息,重度组9.09%宫内死胎、16.36%轻度窒息、20.00%重度窒息、5.45%死产。结论胎盘早剥的发病因素以妊娠期高血压及胎膜早破为主,胎盘早剥越严重,母婴不良结局发生率越高。更多还原

【Abstract】 Objective To investigate the pathogenesis of placental abruption and the effect of different types of placental abruption on maternal and fetal outcomes. Methods A total of 110 patients with placental abruption who had been delivered in the maternity health center of Suzhou Municipal Hospital from July 2013 to June 2016 were randomly selected. According to the patient’s condition, they were divided into mild group and severe group. The incidence factors and maternal and child outcomes were analyzed. Results Inci-dence factors included hypertension during pregnancy(25.45%), intrahepatic cholestasis during pregnancy(13.64%), intrauterine growth restriction(10.91%), polyhydramnios(9.09%), premature rupture of membranes(21.82%), traumatic fatigue(6.36%); mild group was mainly premature rupture of membranes, and severe group was mainly gestational hypertension. Clinical symptoms included abdominal pain(60.91%), backache(8.18%), vaginal bleeding(72.73%), blood sample amniotic fluid(38.18%), spontaneous prema-ture delivery(50.00%), uterine plate hard with tenderness(17.27%); mild and the severe groups were mainly vaginal bleeding and abdominal pain. Mild vaginal delivery accounted for 54.55%, which was significantly higher than 9.09% of the severe group( P <0.05). Maternal outcomes included postpartum hemorrhage(32.73%), placental apoplexy(40.00%), DIC(10.00%), renal failure(5.45%), and shock(4.54%); the proportion of placental and postpartum hemorrhage in the severe group was significantly higher than mild Group(P<0.05). Mild group 5.45% mild asphyxia, severe group 9.09% intrauterine stillbirth, 16.36% mild asphyxia, 20.00% severe asphyxia, 5.45% stillbirth. Conclusion The prevalence of placental abruption is mainly due to hypertensive pregnancy and premature rupture of membranes. The more severe placental abruption, the higher the incidence of adverse outcomes.更多还原