| 娄水平1 喻玲2 汤淼云1 欧阳新宇1 刘君1.胎盘早剥86 例的临床表征与病因分析[J].,2012,12(25):4907-4909 |
| 胎盘早剥86 例的临床表征与病因分析 |
| Clinical Manifestation and Cause Analysis on 86 Cases ofPlacental Abruption |
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| DOI： |
| 中文关键词: 胎盘早剥 诊断 临床表现 |
| 英文关键词: Placental abruption Diagnosis Clinical manifestation |
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| 中文摘要: |
| 目的：分析胎盘早剥漏诊、误诊原因，提高早期确诊率，降低母儿并发症。方法：回顾性分析我院10 年内胎盘早剥患者的临
床资料，分析比较胎盘早剥漏诊与误诊原因。结果：过去十年内我院共检测出胎盘早剥86 例，发生率为0.46%，该类孕妇临床表现
主要为腰腹胀或腹痛、阴道流血、血性羊水。其中，急诊入院患者占（61.6%），有明确诱因39 例，占45.3%，且以妊娠期高血压疾病、
胎膜早破、外伤性因素为主。B 超检出率62.8%。轻型胎盘早剥45 例（52.3%），重型胎盘早剥41 例（47.7%），出现症状到就诊及处
理时间重型胎盘早剥均长于轻型胎盘组P＜0.01。剖宫产分娩60 例（69.8%），阴道分娩26 例（30.2%）。结论：临床发病到临床处理
时间是影响胎盘早剥轻重程度的重要因素；胎盘早剥临床表现易与早产、先兆临产或胎儿窘迫等混淆；后壁胎盘发生胎盘早剥
时，超声容易漏诊。 |
| 英文摘要: |
| Objective: To analyze the cause for missed diagnosis and misdiagnosis on placental abruption and to enhance the accuracy
of early diagnosis and decrease the complication of mother and fetus. Methods: The clinical data of 86 placental abruption cases
from October 2001 to September 2011 in our hospital were retrospectively reviewed. Compare and analyze the missed diagnosis and misdiagnosis
on placental abruption. Results: During October 2001 and September 2011, the incidence of placental abruption was 0.46%,
in which emergence patients accounted for 61.6%, and 39 cases had the predisposing factors(45.3%), mainly including hypertensive disorders
complicating pregnancy, premature rupture of fetal membranes, and traumatic factors. The main clinical manifestations included
lower abdormen pain, vaginal hemorrhage, bloody amniotic fluid. The detection rate of ultrasonography was 62.8%. 45 cases had mild
placental abruption(52.3%), and 41 cases had severe placental abruption(47.7%). The interval from the onset of the initial clinical sign to
treatment for patients with severe placental abruption was longer than those with mild placental abruption (P＜0.01). 60 cases had cesarean
section (69.8%), and 26 cases were vaginal delivery(30.2%). Conclusions: The interval from the onset of the initial clinical sign to treatment
is closely associated with the severity of placental abruption. The clinical manifestations of placental abruption are easily confused
with premature delivery, threatened labor or fetal distress. Missed diagosis by ultrasonography in placental abruption would occur when
the placenta is located on posterior. |
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