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目的:探讨胎盘早剥的病因、早期诊断和处理方法,最大限度减少胎盘早剥对母婴的危害。方法:对2008年10月～2010年10月期间在河南省郑州市人民医院妇产科就诊的70例胎盘早剥患者的诊断和治疗进行回顾性分析。结果:妊娠期高血压疾病(尤其在重型组)相对于其他诱因差异有统计学意义(P<0.05);而样本病例中胎膜早破所诱发的胎盘早剥均为轻型;轻型患者25例有临床表现(64.10%),重型患者29例有临床表现(93.55%),轻型、重型患者的临床表现发生率比较差异有统计学意义(P<0.05);70例患者中行剖宫产分娩46例(65.71%),经阴道分娩24例(34.29%);胎儿死亡1例;重度窒息3例,轻度窒息8例,经积极治疗均获得痊愈。结论:胎盘早剥的产前诊断应结合诱因,临床表现及B超等辅助检查全面分析,做到早诊断、早处理,可减少母婴并发证的发生。
Objective: To investigate the etiology, early diagnosis and treatment of placental abruption, to minimize the harm of placental abruption to maternal and infant. Methods: The diagnosis and treatment of 70 cases of placental abruption treated in obstetrics and gynecology department of Zhengzhou People ’s Hospital of Henan Province from October 2008 to October 2010 were analyzed retrospectively. Results: There were significant differences in gestational hypertension (especially in the severe group) compared with other causes (P <0.05), while in the sample cases, the premature rupture of membranes was mild in 25 cases of mild placental abruption The clinical manifestations (64.10%), 29 cases of severe patients (93.55%), the incidence of clinical manifestations in patients with light and heavy were statistically significant difference (P <0.05); 70 cases of cesarean section delivery 46 (65.71%), vaginal delivery in 24 cases (34.29%), fetal death in 1 case, severe asphyxia in 3 cases and mild asphyxia in 8 cases, all of which were cured after active treatment. Conclusion: The prenatal diagnosis of placental abruption should be combined with the analysis of causes, clinical manifestations and B-ultrasound to make early diagnosis and early treatment, which can reduce the incidence of mother-infant concurrency.