不典型胎盘早剥的临床诊断及治疗效果分析

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英文篇名：Clinical Diagnosis and Treatment Effect Analysis of Atypical Placental Abruption 作者：赵庆萍 英文作者：ZHAO Qing-ping;Departments of Obstetrics, Section Three, Maternal and Child Health Hospital,Qujing, Yunnan Province; 关键词：不典型胎盘早剥 ; 临床诊断 ; 治疗效果 英文关键词：Atypical placental abruption;;Clinical diagnosis;;Therapeutic effect 中文刊名：XTYX 英文刊名：Systems Medicine 机构：云南省曲靖市妇幼保健院产三科; 出版日期：2018-12-05 出版单位：系统医学 年：2018 期：v.3;No.59 语种：中文; 页：XTYX201823042 页数：3 CN：23 ISSN：10-1369/R 分类号：116-118

摘要

目的分析和探索不典型胎盘早剥患者的临床诊治方法以及治疗效果。方法抽取59例2016年5月—2018年5月在该院接受胎盘早剥诊治的患者,将抽取对象根据其是否有不典型胎盘早剥症状分为分为对参考组(n=29)和探讨组(n=30),对全部患者进行实验室检查以及B超检查,若不典型胎盘早剥患者病情无法得到有效确认则需要应用彩超以及其他诊断和医疗方式进一步进行诊断,治疗过程中必须根据胎儿胎心、宫口开放程度以及具体出血量选择自然分娩或者剖宫产。结果探讨组孕妇血小板进行性下降率为33.33%、血红蛋白进行性下降率为33.33%、血纤维蛋白原进行性下降率为43.33%,参考组孕妇分别为48.28%、55.17%、72.41%。探讨组孕产妇血小板进行性下降率低于参考组,两组差异有统计学意义(χ~2=15.237 2,P=0.047 1),血红蛋白进行性下降率低于参考组,两组差异有统计学意义(χ~2=10.238 9,P=0.016 7),血纤维蛋白原进行性下降均明显低于参考组,两组孕产妇对比差异有统计学意义(χ~2=12.234 5,P=0.006 2)。探讨组孕产妇剖宫产率为76.67%、早产体质量发生率为33.33%、产后出血率为33.33%、胎儿窘迫率为46.67%,参考组孕产妇分别为31.03%、13.79%、10.34%、24.14%。探讨组孕产妇剖宫产率高于参考组,2组差异有统计学意义(χ~2=13.023 9,P=0.035 8),早产体质量发生率高于参考组,2组差异有统计学意义(χ~2=11.997 3,P=0.049 2),产后出血率高于参考组,2组差异有统计学意义(χ~2=8.3823,P=0.028 4),胎儿窘迫率明显较参考组孕产妇高,两组差异有统计学意义(χ~2=6.736 5,P=0.043 7)。结论不典型胎盘早剥具有较高的漏诊以及误诊率,对患者加强产前诊断并采取有效的治疗方案能够提高诊断准确率,有助于促进母婴结局改善。
        Objective To analyze and explore the clinical diagnosis and treatment methods and treatment effects of patients with atypical placental abruption. Methods A total of 59 patients who underwent placental abruption at the hospital from May 2016 to May 2018 were enrolled. The subjects were divided into reference group(n=29) and the study group(n=30) according to whether they had atypical placental abruption, all patients with laboratory examination and B-ultrasound examination, if the condition of atypical placental abruption cannot be effectively confirmed, it is necessary to use color Doppler ultrasound and other diagnostic and medical methods for further diagnosis, during the treatment natural childbirth or cesarean section must be chosen according to the fetal heart, the degree of cervix opening,and the specific amount of bleeding. Results The progressive decline rate of platelet in the pregnant women was33.33%, the progressive decline rate of hemoglobin was 33.33%, the progressive decline rate of fibrinogen was 43.33%,and the pregnant women in the reference group were 48.28%, 55.17%, and 72.41%, respectively. The rate of progressive decline in platelet counts in the maternal group was lower than that in the reference group. The difference between the two groups was statistically significant(χ~2=15.237 2, P=0.047 1). The rate of hemoglobin progressive decline was lower than that of the reference group. The difference between the two groups was statistically significant(χ~2=10.238 9,P=0.016 7), the progressive decline of fibrinogen was significantly lower than the reference group, and the difference between the two groups was statistically significant(χ~2=12.234 5, P=0.006 2). The cesarean section rate of the maternal women was 76.67%, the premature body mass rate was 33.33%, the postpartum hemorrhage rate was 33.33%, the fetal distress rate was 46.67%, and the reference group was 31.03%, 13.79%, 10.34%, 24.14%. The cesarean section rate of the pregnant women was higher than that of the reference group. The difference between the two groups was statistically significant(χ~2=13.023 9, P=0.035 8). The incidence of premature birth weight was higher than that of the reference group, and the difference between the two groups was statistically significant(χ~2=11.997 3, P=0.049 2), the postpartum hemorrhage rate was higher than the reference group, the difference between the two groups was statistically significant(χ~2=8.382 3, P=0.028 4), the fetal distress rate was significantly higher than that of the reference group, and the difference between the two groups was statistically significant(χ~2=6.736 5, P =0.043 7). Conclusion Atypical placental abruption has a high rate of missed diagnosis and misdiagnosis. Strengthening prenatal diagnosis and adopting effective treatment plan can improve the accuracy of diagnosis and improve the outcome of maternal and infant outcomes.

引文

[1]吴鹤.不典型胎盘早剥的诊断及治疗探讨[J].当代医学,2015(2):96.
    [2]成星.不典型胎盘早剥的临床诊断与治疗效果观察[J].临床医药文献电子杂志,2018,5(3):59-60.
    [3]康雪芳.症状不典型胎盘早剥患者的临床症状及护理措施[J].母婴世界,2017(6):139.
    [4]于军琴.不典型胎盘早剥的临床分析[J].中国医药指南,2016,14(17):217-218.
    [5]牟大英,黄露,路祥会.不典型胎盘早剥发病相关因素及诊治分析[J].现代医药卫生,2015(6):870-872.
    [6]李友碧.不典型胎盘早剥的临床诊断及治疗效果分析[J].大家健康,2016,10(3中旬版):101.
    [7]官世红,刘文兰.不典型胎盘早剥的临床诊治效果分析[J].数理医药学杂志,2015(2):179.
    [8]张清素.不典型胎盘早剥的临床诊治效果分析[J].世界最新医学信息文摘:连续型电子期刊,2015(29):90-91.
    [9]杨丽,陈贞霞.早期胎盘早剥13例临床观察与分析[J].中国医药指南,2015(26):141-142.
    [10]郑秀菊.不典型胎盘早剥的临床诊断及治疗效果分析[J].中国医药指南,2016,14(2):69.