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目的探讨影响胎盘早剥临床结局的相关因素,提高临床识别和处理技能。方法对2008年元月至2011年元月3年间郑州妇幼保健院收治的247例胎盘早剥患者的临床资料进行回顾性分析。其中子痫前期伴发胎盘早剥144例,原因不明胎盘早剥103例,采用单因素及多因素回归分析影响围产结局和产科结局相关因素。结果首发临床征象分析显示子痫前期组以超声异常为首发征象显著多于原因不明胎盘早剥组,重度早剥以腹痛为首发征象者显著多于轻度早剥,子痫前期、首发临床征象至临床处理时限是胎盘早剥轻重程度的独立影响因素。出现首发临床征象至临床处理时限是发生产后出血的独立影响因素。子痫前期、重度胎盘早剥及临床首发征象至临床处理时限是胎死宫内的独立影响因素。临床首发征象至临床处理时限是新生儿窒息的独立影响因素。结论子痫前期是影响胎盘早剥病情程度的高风险因素。
Objective To explore the factors influencing the clinical outcome of placental abruption and to improve the clinical identification and treatment skills. Methods The clinical data of 247 cases of placental abruption admitted from Zhengzhou MCH in January 2008 to January 2011 were retrospectively analyzed. 144 cases of preeclampsia with placental abruption, unexplained 103 cases of placental abruption, using univariate and multivariate regression analysis of perinatal outcomes and obstetric outcome-related factors. Results The first clinical signs analysis showed that the signs of ultrasound-induced preeclampsia were significantly more than those of unexplained placental abruption group, severe abortion with abdominal pain as the first sign of symptoms were significantly more than mild abruption, preeclampsia, the first clinical signs To the clinical treatment time limit is the severity of placental abruption independent factors. The first clinical signs appear to clinical treatment of time is the occurrence of postpartum hemorrhage independent influencing factors. Pre-eclampsia, severe placental abruption and clinical signs of the first clinical treatment to the time limit is an independent factor fetal death. First signs of clinical treatment to the clinical duration of neonatal asphyxia is an independent factor. Conclusion Preeclampsia is a high risk factor affecting the severity of placental abruption.