胎盘早期剥离的治疗探讨

Study of the therapy of placenta abruption

目的 探讨提高胎盘早期剥离 (胎盘早剥 )的治疗水平与改善母儿围生结局的措施。方法 回顾性分析 6 8例胎盘早剥患者的临床资料。结果 胎盘早剥发生率为 1.5 0 % ,产前诊断率 4 1.18% ,胎儿宫内窘迫率 2 6 .4 7% ,围生儿病死率 10 .2 9% ,产后出血率 2 3.5 3% ,失血性休克率 11.76 % ,弥漫性血管内凝血(DIC)发生率 8.82 % ,子宫卒中率 17.6 5 %。结论 及时终止妊娠对改善母儿围生结局至关重要 ,子宫卒中不是子宫切除的指征 ,出现DIC尽快终止妊娠、输新鲜血 ,切勿盲目使用肝素。

Objective To investigate the therapy of placenta abruption and the measures to improve the outcome of perinatology.Methods Clinical data of 68 cases of placenta abruption were retrospectively analyzed. Results The rate of placenta abruption,the rate of antenatal diagnosis,the rate of intrauterine growth retardation(INGR),perinatal mortality,postpartum hemorrhage rate,the incidence of DIC,and the rate of uteroplacental apoplexy were 1.50%,41.18%,26.47%,10.29%,23.53%,11.76%,8.82% and 17.65%,respectively. Conclusion Timely termination of pregnancy is the key to the perinatal outcome of mother and infant.Uteroplacental apoplexy is not the indication of hysterectomy.The termination of pregnancy and the transfusion of fresh blood should be carried out as soon as possible when DIC occurs.Heparin should not be blindly used.