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目的:探讨前置胎盘合并胎盘植入的危险因素、临床特点、诊治及母婴结局。方法:回顾分析2008年1月至2014年1月我院诊治的206例前置胎盘患者的临床资料,其中24例合并胎盘植入(研究组),182例单纯前置胎盘患者(对照组)。比较两组患者的临床资料、诊治过程、母婴结局。结果:前置胎盘合并胎盘植入的发生率为0.16%。孕次、流产史、前置胎盘类型、子宫瘢痕史是引起前置胎盘合并胎盘植入的危险因素(P<0.05)。研究组的产后出血量、剖宫产率及失血性休克发生率明显高于对照组,差异有统计学意义(P<0.05);而两组的新生儿早产、窒息发生率及死亡率比较,差异无统计学意义(P>0.05)。结论:孕次、流产次、瘢痕子宫、完全型前置胎盘是胎盘植入的高危因素,前置胎盘孕产妇孕期出血应高度警惕胎盘植入的可能性,应注重预防,提高分娩前诊断率,及时处理,保证母儿安全。
Objective: To explore the placenta accreta placenta previa placenta combined with risk factors, clinical features, diagnosis and treatment and maternal and infant outcomes. Methods: The clinical data of 206 cases of placenta previa treated in our hospital from January 2008 to January 2014 were analyzed retrospectively. Among them, 24 cases were complicated with placenta accreta (study group), 182 cases with placenta previa (control group) . Compare the clinical data of two groups of patients, diagnosis and treatment process, maternal and infant outcomes. Results: The incidence of placenta accreta was 0.16%. Pregnancy, abortion history, type of placenta previa, and history of uterine scar were the risk factors for placenta accreta placenta previa (P <0.05). The incidence of postpartum hemorrhage, cesarean section rate and hemorrhagic shock in the study group were significantly higher than those in the control group (P <0.05). However, the incidence of postpartum hemorrhage, asphyxia and mortality in the two groups were statistically significant The difference was not statistically significant (P> 0.05). Conclusion: Pregnancy, abortion, scarring uterus and complete placenta previa are risk factors of placenta accreta. Placenta previa placenta previa bleeding should be highly alert to the possibility of placenta accreta, should pay attention to prevention, improve the diagnostic yield before delivery , In a timely manner to ensure the safety of mother and child.