40例凶险型前置胎盘的临床特征分析

Clinical Analysis of 40 Cases of Pernicious Placenta Previa

目的:分析凶险型前置胎盘的临床特征,探讨该疾病的危害、诊治措施,提高对其的认识。方法:纳入2013年1月至2016年1月于我院产科分娩的前置胎盘孕妇207例为对象,行回顾性分析,将40例凶险型前置胎盘孕妇划入观察组,167例普通型前置胎盘孕妇划分为对照组。统计并对比2组临床资料、诊断结果、手术情况、新生儿结局。结果:观察组首次出现阴道流血时间为孕(33.5±2.7)周,明显晚于对照组孕(30.7±3.8)周,差异有统计学意义(P<0.05);观察组胎盘植入13例(32.5%)、产后出血30例(75.0%)、子宫切除7例(17.5%)、术中紧急输血26例(65.0%),对照组分别出现6例(3.6%)、37例(22.2%)、1例(0.6%)、14例(8.4%),观察组上述不良事件发生率均明显高于对照组,上述差异均有统计学意义(P<0.05);观察组术中出血量(2178.5±337.4)ml,明显多于对照组(417.5±188.4)ml,差异均有统计学意义(P<0.05)。2组新生儿结局差异无统计学意义(P>0.05)。结论:相较于普通型前置胎盘,凶险型前置胎盘胎盘植入、产后出血、子宫切除、术中紧急输血发生率更高,对孕产妇威胁较大;但凶险型前置胎盘对新生儿结局可能并无影响。

Objective： Analysis of clinical features of placenta previa, investigate the harm and treatment measures of the disease, to improve the knowledge. Methods：Pregnant women with placenta previa included in January 2013 to January 2016 in our hospital obstetric delivery 207 cases as the object of study, were retrospectively analyzed, 40 cases of placenta previa pregnant women as the observation group, 167 cases of normal pregnant women with placenta previa were divided into control group. Statistics and comparison of 2 groups of clinical data, diagnosis, operation, neonatal outcome. Results： The observation group for the first time for pregnancy vaginal bleeding （33.5 ＋ 2.7） weeks, significantly later than that of the control group （30.7 ＋ 3.8） weeks of pregnancy, the difference was statistically significant （P 〈 0.05）; observation group of 13 cases of placenta accreta （32.5%）, 30 （75%） cases of postpartum hemorrhage, uterine resection in 7 cases （17.5%）, during an emergency blood transfusion in 26 cases （65%）, the control group were 6 cases （3.6%）, 37 cases （22.2%）, 1 cases （0.6%）, 14 cases （8.4%）, the observation group the incidence of adverse events was significantly higher than the control group, the differences were statistically significant （P 〈 0.05）; observation group the amount of intraoperative bleeding （2178.5 ＋ 337.4） ml, significantly higher than the control group （417.5 ＋ 188.4） ml, the differences were statistically significant （P 〈 0.05）. There was no significant difference in the outcome between the 2 groups （P 〉 0.05）. Conchmion： Compared with the ordinary type of placenta previa, placenta previa accreta, postpartum hemorrhage, hysterectomy, intraoperative emergency blood transfusion have higher rates, greater threat to pregnant women; but the placenta previa may have no effect on neonatal outcome.