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为探讨以脐带因素为主要致死原因的死胎临床病理特征 ,对 86 0例围产儿尸检结果进行统计 ,总结出与胎儿死亡有关的脐带病变 94例 ,并列表分析。脐带扭转压迫出血坏死 (37.2 % )及脐带缩窄 (2 0 .2 % )为最主要的脐带因素致死原因。前者大多以足月妊娠为主 (48.6 % ) ,脐带扭转程度与胎儿死亡的快慢成正比。后者胎儿死亡多发生在孕 36w前 (78.9% ) ,缩窄的程度和胎儿体重大小与胎儿死亡的孕周成反比。另外脐动、静脉炎 ,脐动、静脉周围炎 ,血栓形成 ,单脐动脉等也各占不同的比例。这些死胎中部分病例是以脐带病变致死的直接原因。还有些病例因与其他因素共同作用的综合因素而致死。脐带因素是引起死胎的一重要原因 ,而且绝大多数目前在国际国内医学上均无法预防。如果在临床上加强产前宣传教育 ,提高孕妇自我监护的能力 ,小部分病例的围产儿是可能有生存机会的。
In order to explore the clinical and pathological features of stillbirth with umbilical cord as the main cause of death, the autopsy results of 86 0 cases were statistically analyzed, and 94 cases of umbilical cord lesions related to fetal death were summarized and analyzed. Umbilical cord compression hemorrhage necrosis (37.2%) and umbilical cord narrowing (20.2%) are the leading causes of umbilical cord death. Most of the former full-term pregnancy (48.6%), the degree of umbilical cord torsion is proportional to the rate of fetal death. The latter fetal death occurred in 36 weeks before pregnancy (78.9%), the degree of constriction and fetal weight and fetal death is inversely proportional to the gestational age. In addition to umbilical movement, phlebitis, umbilical movement, peripheral venous inflammation, thrombosis, single umbilical artery, also each of the different proportions. Some of these stillbirths are the direct cause of death from umbilical cord lesions. Other cases have also been fatal due to a combination of factors that together with other factors. Umbilical cord factor is an important cause of stillbirth, and the vast majority of the current international and domestic medical are not preventable. If the clinical prenatal education to strengthen and improve the ability of pregnant women to self-monitoring, a small number of cases of perinatal children may have the chance to survive.