【作者】 李萍；

【导师】 刘兴会；

【作者基本信息】 四川大学 ， 妇产科学， 2004， 硕士

【摘要】 目的:探讨前置胎盘及前置胎盘并发胎盘粘连或植入的临床特点及围生期处理;并评估彩色多普勒超声诊断前置胎盘并发胎盘植入的价值。 方法:回顾性分析2000年1月—2003年12月在四川大学华西二院最终确诊为前置胎盘的228例患者的临床资料;并对2002年6月—2003年12月在该院经产前彩色超声多普勒诊断的19例前置胎盘患者进行跟踪调查。 结果:①前置胎盘易并发胎盘粘连或植入,孕妇年龄越大、流产次数越多,并发胎盘粘连或植入的机率越大(p<0.05);且并发胎盘粘连或植入使产时出血量大大增加(p<0.01)。②彩超产前诊断前置胎盘并发胎盘植入的阳性预测值为70.0%,阴性预测值为88.89%,有临床运用价值。 结论:前置胎盘并发胎盘粘连或植入对终止妊娠时母儿的生命安全威胁巨大,彩超产前诊断前置胎盘并发胎盘植入有一定准确性,能够有效指导临床工作,降低因不可预见的产时大出血而导致的母儿死亡。更多还原

【Abstract】 Objective: Discuss the clinic character and perinatal period disposal of placenta previa with placenta adhesion, accreta, increta and percreta. And assessing the value of the color Doppler ultrasound in the diagnosis of placenta previa with placenta accreta/increta/percreta.Method: Retrospectivly analyzing the 228 clinic cases which were ultimately diagnosed placenta previa in the 2^nd hospital of SiChuan university from Jan to Dec 2003.And tracing the 19 prenatal patients who were diagnosed placenta previa by color Doppler ultrasound imige in the 2^nd hospital of SiChuan university from June 2002 to December 2003.Result: ① Placenta adhesion and placenta accreta/increta/percreta arerelated to the age and the abortive frequency of the pregnant patient（p<0.05） ,and they are strongly related to the amount of hemrrohage. ②By using the prenatal color Doppler ultrasound imige to diagnose theplacenta previa with placenta accreta/increta/percreta, the positive predictive value is 70.0%;the negative predictive value is 88.89%. It can be used to guide the clinic work.Conclusion :Placenta previor adhesion ,accreta/increta/percreta are related to the age and the abortive frequency of the pregnant patient.They are closely affect the amount of hemrrohage while terminating the pregnancy.Thus threaten the security of the mother and the fetus. Using the prenatal color Doppler ultrasound imige can guide the clinic work to induce the death of the mother and the fetus by induce the unpredictively bleeding while terminating the pregnancy.更多还原