处理速度对胎盘早剥临床结局的影响及防范(1)
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[摘要] 目的：探讨临床处理速度对胎盘早剥临床结局的影响，提高临床识别和处理技能，降低危害程度。方法：回顾性分析我院2003年1月～2010年12月收治的92例胎盘早剥患者的临床资料。分析影响围产结局和产科结局的相关因素。结果：92例胎盘早剥孕妇院内发生胎盘早剥18例(19.57%)，院外发生胎盘早剥74例(80.43%)，重度胎盘早剥31例(33.70%)，首发临床征象至处理时限为20.00～700.00 min，轻度胎盘早剥61例(66.30%)，首发临床征象至处理时限为30.00～180.00 min,说明临床处理时限越长，胎盘早剥症状越重。本组92例胎死宫内18例(19.57%)，新生儿重度窒息12例(13.43%)，轻度窒息18例(19.57%)；新生儿窒息率为32.61%。结论：临床处理时限是影响胎盘早剥轻重程度的重要因素,也是影响产科和围产结局的重要因素。
[关键词] 胎盘早剥；产科结局；围产结局；处理速度；防范
[中图分类号] R714.43 [文献标识码] B [文章编号] 1673-7210(2011)07(b)-066-03
Influence of processing speed on clinical outcomes in placental abruption
LI Haiying
Guangdong Province Guanlan People's Hospital, Shenzhen 518110, China
[Abstract] Objective: To investigate the Influenceofprocessing speed on clinical outcomes in placental abruption so as to increaseclinical recognition and treatment in improving the skills and reduce the degree of harm. Methods: A retrospective analysis of our hospital from January 2003 to December 2010 92 patients admitted to the clinical data of patients with placental abruption. Univariate and multivariate regression analysis of perinatal outcome and obstetric outcomes of the relevant factors. Results: Ninty-two cases of placental abruption occurred in 18 cases of nosocomial pregnant women (19.57%), 74 cases of placental abruption occurred outside the hospital(80.43%), severe placental abruption in 31 cases(33.70%), first clinical signs to the time limit for processing 20.00 - 700.00 min, mild placental abruption 61 (66.30%), first clinical signs to deal with a time limit of 30.00 - 180.00 min, that the longer period of clinical treatment, placental abruption, the more severe symptoms. The group of 92 patients with fetal death in 18 cases(19.57%), neonatal severe asphyxia in 12 cases(13.43%), mild asphyxia in 18 cases(19.57%); neonatal asphyxia(32.61%). Conclusion: The clinical management of time is an important factor in severity of placental abruption as well as obstetric and perinatal outcome of important factors.
[Key words] Placental abruption; Obstetric outcomes; Perinatal outcome; Processing speed; Prevention
胎盘早剥的发病原因尚不十分清楚，其作用机制是妊高症引起子宫底蜕膜层的小动脉发生动脉粥样硬化，毛细血管缺血坏死和破裂出血，血液流至底蜕膜层，使得胎盘易从子宫壁剥离而发生胎盘早剥[1]。对母婴危害很大，易造成早产、难产，并促进胎儿窒息发生率及新生儿疾病增加。所以临床应及时作出诊断，予以积极有效地处理，防范胎盘早剥。笔者通过对2003年1月～2010年12月收治的92例胎盘早剥患者进行治疗 ......
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