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目的:研究前置胎盘(PP)、胎盘粘连(PA)及胎盘植入(PI)临床表现及病理资料。方法:收集该院产科60例住院分娩孕妇根据产后胎盘病理诊断分组,其中包括:PP组30例,PP合并PA组20例,PP合并PI组10例。收集正常分娩孕妇20例为正常妊娠(NP)组,比较其临床资料以及经HE染色的胎盘病理资料。结果:PP组、PP合并PA组、PP合并PI组三组与NP组在孕妇年龄、孕次、产次、分娩孕周、人工流产史、引产史及剖宫产史方面比较,差异均有统计学意义(P<0.05);在产前出血、剖宫产分娩、产后出血、子宫切除术、子宫动脉栓塞术及产褥感染方面比较,差异均有统计学意义(P<0.05);在病理资料方面比较,在蜕膜层、胎盘隔及合体结节均出现减少或消失,在绒毛微血管和合体滋养细胞微绒毛存在明显增多,差异均有统计学意义(P<0.05)。结论:PP、PA及PI临床表现与病理结果一致,滋养细胞侵袭行为表现明显。
Objective: To study the clinical manifestations and pathological features of placenta accreta (PP), placenta accreta (PA) and placenta accreta (PI). Methods: A total of 60 obstetric and obstetric women with infertility were enrolled in this study. The patients were divided into three groups according to the pathological diagnosis of postpartum placenta. Among them, there were 30 cases of PP group, 20 cases of PP combined with PA group and 10 cases of PP combined with PI group. 20 normal pregnant women were collected for normal pregnancy (NP) group. The clinical data and placenta pathological data were compared. Results: There were significant differences in the age, pregnancy time, parity, labor gestational age, abortion history, induced abortion history and cesarean section history between PP group, PP combined with PA group, PP combined with PI group and NP group (P <0.05). The differences were statistically significant in prepartum hemorrhage, cesarean section delivery, postpartum hemorrhage, hysterectomy, uterine artery embolization and puerperal infection (P <0.05) Compared with the pathological data, there was a decrease or disappearance of the decidua, placental septum and syncytial nodules in the villus microvasculature and syncytiotrophoblastic microvilli, the differences were statistically significant (P <0.05). Conclusion: The clinical manifestations of PP, PA and PI are consistent with the pathological findings. The behavior of trophoblast invasion is obvious.