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目的探讨不同程度胎盘早剥孕产妇的发病诱因、临床表现、孕产妇和围产儿结局,为临床诊治提供参考,以减少母婴危害。方法选取95例胎盘早剥患者,并参考国内外相关文献报道,对其临床资料进行回顾性分析。结果本组95例胎盘早剥患者中,有明确发病诱因者79例,其中合并妊娠期高血压疾病者居多。临床表现多为腹痛、阴道流血、子宫板样硬、血性羊水。Ⅰ度、Ⅱ度、Ⅲ度胎盘早剥剖宫产率、新生儿窒息发生率差异无统计学意义(P>0.05),但产后出血、子宫胎盘卒中、DIC差异有统计学意义(P<0.05),新生儿转科率及围生儿死亡率差异有统计学意义(P<0.01)。结论胎盘早剥的诊断应注重其病史及诱因,积极地防患和医治胎盘早剥的高危因素,早期识别诊断,及时处理,可改善围生期母婴结局。
Objective To investigate the causes, clinical manifestations, maternal and perinatal outcomes of pregnant women with different degrees of placental abruption, and to provide reference for clinical diagnosis and treatment to reduce the risk of maternal and infant. Methods Ninety-five patients with placental abruption were selected, and their clinical data were retrospectively analyzed with reference to relevant literature at home and abroad. Results In this group of 95 cases of placental abruption patients, there are 79 cases of clear inducement of pathogenesis, including the majority of hypertensive disorders complicating pregnancy. Mostly clinical manifestations of abdominal pain, vaginal bleeding, uterine plate-like hard, bloody amniotic fluid. There was no significant difference in the incidence of cesarean section and neonatal asphyxia between Ⅰ degree, Ⅱ degree and Ⅲ degree placental abruption (P> 0.05), but the difference was statistically significant between postpartum hemorrhage, uterine placental stroke and DIC (P <0.05) ), Neonatal morbidity and perinatal mortality were significantly different (P <0.01). Conclusion The diagnosis of placental abruption should pay attention to its history and incentives, and actively prevent and treat high risk factors for placental abruption, early identification and timely diagnosis and treatment can improve perinatal maternal and infant outcomes.