胎盘早剥临床诊疗与危险因素分析(1)
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[摘要] 目的 探讨胎盘早剥及其并发症的诊断、治疗措施及孕妇发生胎盘早剥的相关危险因素。 方法 回顾性分析我院32例胎盘早剥患者的临床资料，分析胎盘早剥及并发症的诊断、治疗措施及预后。另选取50例正常产妇为对照组，比较胎盘早剥与对照组的临床资料，并对发病相关危险因素进行Logistic回归分析。 结果 胎盘早剥产前诊断率为43.8%，产后出血率为37.5%，肾衰竭率为6.3%，所有产妇经对症治疗后均痊愈；Logistic回归分析结果显示胎膜早破、高血压、羊水量异常、吸烟史和高龄产妇是胎盘早剥的危险因素，且相关性依次增加。 结论 早期诊断、终止妊娠是有效治疗胎盘早剥及其并发症的关键，但应合理选择分娩方式及治疗方法。胎盘早剥是由多因素引起的，应针对性预防，对高危孕妇进行重点监测。
[关键词] 胎盘早剥；早期诊断；治疗；高危因素
[中图分类号] R714.43 [文献标识码] A [文章编号] 1673-7210(2012)02(b)-0025-03
Analysis of the clinical practice and risk factors of placenta abruption
ZOU Weili
Department of Gynecology and Obstetrics, Women and Child Health Hospital of Longchuan County, Guangdong Province, Longchuan 517300, China
[Abstract] Objective To investigate the diagnosis and therapy of placenta abruption and its correlation factors for the maternal. Methods Clinical data of 32 patients with placenta abruption were retrospectively analyzed, and discussed the diagnosis and treatment of complications. Another 50 normal maternal were selected as control group. The clinical-data and the correlation factors of the two groups were compared, and the correlation risk factors were analyzed by Logistic regression analysis. Results The rate of prenatal diagnosis, postpartum hemorrhage and acute renal failure for the placenta abruption were 43.8%, 37.5% and 6.3%, and all the maternal recovered after treatment; the results of Logistic regression analysis found that premature rupture of membranes, hypertension, abnormal amniotic fluid volume, cigarette smoking and older mothers were the risks of placenta abruption and the correlation increased in turn. Conclusion Early diagnosis and timely termination of pregnancy are the key of treating placenta abruption and its complications, while should choose reasonable mode of delivery and treatment. Placenta abruption is caused by multiple factors, prevention should be targeted to focus on monitoring high-risk pregnant women.
[Key words] Placenta abruption; Early diagnosis; Treatment; Risk factors
胎盘早剥是指妊娠20周后或分娩期，正常位置的胎盘在胎儿分娩前部分或完全从子宫壁剥离，是造成怀孕后期阴道出血、孕妇及胎儿围生期死亡的主要原因[1]，国内发病率为0.46%～2.10%[2]。胎盘早剥具有起病隐匿、进展快等特点，早期诊断治疗是关键。另一方面，胎盘早剥确切发病机制仍不明确，目前认为与高危因素有关[3]，因此，发现及预防胎盘早剥的高危因素仍是临床产科关注的焦点。
1 资料与方法 ......
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