| 杨书红,刘惜文,吴媛媛,刘海意,曾万江,冯 玲,邓东锐,龚 洵.44例不同孕周脐带脱垂患者的临床资料分析[J].,2019,19(19):3648-3652 |
| 44例不同孕周脐带脱垂患者的临床资料分析 |
| Analysis of 44 Patients with Umbilical Cord Prolapse with Different Gestational Week |
| 投稿时间：2019-03-23 修订日期：2019-04-18 |
| DOI：10.13241/j.cnki.pmb.2019.19.011 |
| 中文关键词: 脐带脱垂 孕周 围产儿结局 预防 |
| 英文关键词: Cord prolapse Gestational age Perinatal outcome Prevention |
| 基金项目:国家自然科学基金项目（81501227）；中央高校基本科研业务费专项资金资助（2017KFYXJJ119） |
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| 中文摘要: |
| 摘要 目的：探讨不同孕周脐带脱垂患者相关因素的差异。方法：回顾性比较分析2012 年01月至2017 年12月我院收治的44例脐带脱垂患者的临床资料。将患者按照脐带脱垂发生的孕周分为足月组、早产组及流产组，使用SPSS18.0 统计软件处理数据。结果：我院近六年脐带脱垂总的发病率为1.829/1000。44例患者中，足月组7人，占15.91%；早产组22人，占50%；流产组15人，占34.09%。三组患者的年龄、产次及孕次均无显著统计学差异(P>0.05)。足月组新生儿apgar评分最高，与其它两组相比均有统计学差异(P<0.05)，早产组apgar评分显著高于流产组(P<0.05)；足月组剖宫产率为100%，早产组为63.64%，流产组则为13.13%，三组患者剖宫产率比较存在统计学差异(P=0.000)，足月组剖宫产率与早产组比较无统计学差异(P=0.075)，足月组剖宫产率与流产组比较有统计学差异(P=0.000)，早产组剖宫产率与流产组比较有统计学差异(P=0.003)。足月组异常胎方位的发生率显著低于早产组(P=0.038)。早产组胎儿数(单胎、双胎)与足月组及流产组相比均有统计学差异(P＜0.05)，而足月组与流产组胎儿数则无统计学差异(P>0.05)。早产组双胎妊娠占比例更高。三组患者发生脐带脱垂的地点比较无统计学差异(P=0.256)。结论：不同孕周是否发生脐带脱垂与患者的年龄、产次、孕次及地点无关。脐带脱垂较多发生于早产者，且早产患者中双胎、异常胎方位发生率更高。一旦发生脐带脱垂，尤其是有机会存活的胎儿，应以最快的方式娩出胎儿，提高新生儿存活几率。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the difference of associated factors among three groups patients (term group, gestational week ≥37, preterm group, gestational week ≥28 , ＜37, and abortion group＜28) with umbilical cord prolapse. Methods: A retrospective analysis was performed in the 44 cases with umbilical cord prolapse from January 2012 to December 2017 in our hospital. The patients were divided into three groups: term group, preterm group and abortion group. The data was analyzed with SPSS 18.0. Results: The total incidence of umbilical cord prolapse was 1.829/1000 in the last six years. The distribution of patients with umbilical cord prolapse was analyzed. Among the 44 patients, the term group includes 7 patients, accounting for 15.91%; preterm group was 22, accounting for 50%; The abortion group accounted for 34.09%. There was no statistically significant difference among the three groups in age, parity and gravida(P>0.05). The results showed that the apgar score was the highest in the group of the term, which was statistically different with the other two group(P<0.05)s Also, there was significant difference between the group of preterm and abortion. In the term group, cesarean section was the only way of delivery, the rate was 100%. The preterm group was 63.64%, while 13.13% in the abortion group. There were significant differences among the three groups for the delivery way, P=0.000. The term group and preterm group had no significant difference (P=0.075), while term and abortion group had significant difference (P=0.000), and premature and abortion group also had significant difference (P=0.003). The results showed that abnormal fetal orientation was more common in patients of preterm group(P＜0.05). Also, the proportion of twin pregnancy in preterm group was higher than the other two(P＜0.05). There was no significant difference among the three groups of the location for umbilical cord prolapse(P=0.256). Conclusion: Whether or not umbilical cord prolapse occurred at different gestational weeks was independent of the patient's age, parity, gravida. and location. The incidence of umbilical cord prolapse was higher in preterm group, and the incidence of twins and abnormal fetal position was also higher in these patients. Once umbilical cord prolapse occurs in pregnant women, for the sake of increasing the infant survival ration, the delivery of the fetus should be performed in the fastest way. |
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