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目的探讨胎盘早剥临床处理时限对妊娠结局的影响,以提高临床识别能力及处理技能,减少母儿不良结局。方法选取2000年1月-2013年12月该院收治的胎盘早剥患者91例为研究对象,回顾性分析其临床资料。结果 91例胎盘早剥患者中,重度早剥19例,轻度早剥72例。其中妊娠期高血压疾病为最常见的发病诱因(49.45%)。重度早剥组与轻度早剥组腹痛、胎心异常情况比较,差异有统计学意义(P<0.05),而频繁宫缩、血性羊水、阴道流血等胎盘早剥典型症状比较,差异无统计学意义(P>0.05)。在首发临床征象至处理时限方面,重度早剥组与轻度早剥组比较,差异有统计学意义(P<0.05)。在重度早剥及首发临床征象至处理时限方面,产后出血组、产后出血无弥散性血管内凝血(DIC)组与无产后出血组比较,差异有统计学意义(P<0.05);而产后出血DIC组与产后出血无DIC组比较,差异无统计学意义(P>0.05);死胎组与活产组、早期新生儿死亡组与存活组、新生儿重度窒息组与无窒息组比较,差异均有统计学意义(P<0.05)。结论临床处理时限是影响胎盘早剥严重程度和围产结局的重要因素。
Objective To investigate the effect of clinical treatment time of placental abruption on pregnancy outcomes to improve the ability of clinical identification and treatment skills and reduce the adverse outcomes of maternal and child. Methods Totally 91 cases of placental abruption admitted in our hospital from January 2000 to December 2013 were selected as the research object, and the clinical data were retrospectively analyzed. Results 91 cases of placental abruption patients, 19 cases of severe abruption, mild abruption in 72 cases. One of the most common causes of pregnancy-induced hypertension (49.45%). There were significant differences in abdominal pain and abnormal fetal heart rate between severe ablation group and mild abruption group (P <0.05), while no significant difference was found in the typical symptoms of placental abruption such as frequent uterine contractions, bloody amniotic fluid, vaginal bleeding Significance (P> 0.05). In the first clinical signs to the treatment time limit, severe scaring group and mild scaring group, the difference was statistically significant (P <0.05). There were significant differences in the rate of severe abla- tion and initial clinical signs to treatment time between postpartum hemorrhage group, postpartum hemorrhage-free disseminated intravascular coagulation (DIC) group and postpartum hemorrhage group (P <0.05), while postpartum hemorrhage DIC group and postpartum hemorrhage without DIC group, the difference was not statistically significant (P> 0.05); stillbirth group and live birth group, early neonatal death group and survival group, neonatal severe asphyxia group and no asphyxia group, the difference was There was statistical significance (P <0.05). Conclusion The duration of clinical treatment is an important factor affecting the severity of placental abruption and perinatal outcome.