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目的研究晚期妊娠胎盘病理变化与妊娠并发症及围产儿结局的关系。方法选择2010年6月-2012年12月在厦门市中医院876例晚期高危妊娠分娩后胎盘均送病理检查的临床资料,分析胎盘病理变化与妊娠并发症的关系;特别分析其中最常见的两类胎盘病理变化:炎症性变化、绒毛缺血缺氧病变对围产儿结局的影响,取炎症性病变组359例,绒毛缺血缺氧病变组387例,分别与正常胎盘组(送检无病理改变)89例作对照。结果送检胎盘876例,正常胎盘89例,占15.16%;有病理改变787例,占89.84%,其中胎盘形状及发育异常18.15%,炎症病变40.99%,绒毛缺血缺氧病变44.18%,肿瘤性病变1.37%。常见的炎症性病变组、绒毛缺血缺氧病变组中不良围产儿结局:如新生儿窒息、死胎的发生率与正常胎盘组比较,差异均有统计学意义(P<0.05)。结论胎盘的病理变化与妊娠并发症密切相关,尤其胎盘炎症性病变与胎盘绒毛缺血缺氧性病变可直接影响围产儿结局,必须重视胎盘的病理检查。
Objective To study the relationship between placental pathology and pregnancy complications and perinatal outcome in late pregnancy. Methods From June 2010 to December 2012 in Xiamen City Hospital of traditional Chinese medicine 876 cases of high-risk pregnancy delivery of placenta after delivery of pathological examination of clinical data to analyze the relationship between placental pathology and pregnancy complications; special analysis of which the most common two Placenta-like pathological changes: inflammatory changes, hypoxia hypoxia lesions perinatal outcome, inflammatory lesions in 359 cases, 387 cases of hypoxia and hypoxia lesions group, respectively, with the normal placenta group (no pathological examination Change) 89 cases as a control. Results There were 876 cases of placenta and 89 cases of normal placenta, accounting for 15.16%. There were 787 cases of pathological changes, accounting for 89.84%, of which 18.15% were placental abnormalities, 40.99% of inflammatory lesions, 44.18% of hypoxia and hypoxia lesions, 1.37% of the lesions. Common inflammatory disease group, hypofusion hypoxic ischemic disease group of poor perinatal outcomes: such as neonatal asphyxia, the incidence of stillbirth compared with the normal placenta group, the difference was statistically significant (P <0.05). Conclusion The pathological changes of placenta and pregnancy complications are closely related, especially the placental inflammatory lesions and placental hypoxia hypoxia lesions can directly affect the outcome of perinatal children, we must pay attention to the pathological examination of the placenta.