[1]连旭波*,韦春杏.妊娠期凶险型前置胎盘的核磁共振成像诊断价值与妊娠结局的关系[J].中国计划生育和妇产科,2018,(１):28-31.
　LIAN Xu-bo*,WEI Chun-xing.MRI diagnosis value of pernicious placenta previa and its relationship with pregnancy outcome[J].Chinese Journal of Family Planning & Gynecotokology,2018,(１):28-31.
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妊娠期凶险型前置胎盘的核磁共振成像诊断价值与妊娠结局的关系
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2018年１期
页码:
28-31
栏目:
论著与临床
出版日期:
2018-01-25

文章信息/Info

Title:
MRI diagnosis value of pernicious placenta previa and its relationship with pregnancy outcome
作者:
连旭波*; 韦春杏
龙岗区妇幼保健院产科
Author(s):
LIAN Xu-bo*;  WEI Chun-xing
Department of Obstetrics, Shenzhen Longgang Women and Children Health Care Hospital, Shenzhen Guangdong 518172,P.R.China
关键词:
妊娠期胎盘植入; MRI; 凶险型前置胎盘; 妊娠结局
Keywords:
gestation placenta implantation;  magnetic resonance imaging;  pernicious placenta previa;  pregnancy outcome
分类号:
R 714.2
摘要:
目的探讨妊娠期凶险型前置胎盘（pernicious placenta previa, PPP）的核磁共振成像（magnetic resonance imaging,MRI)诊断价值与妊娠结局的关系。方法 回顾性分析2012年3月至2015年6月龙岗区妇幼保健院收治的疑似前置胎盘(placenta previa,PP)的妊娠晚期孕妇87例的临床资料，均行MRI检查，根据手术或病理结果确诊80例，分为观察组（PPP，50例）和对照组（非凶险型PP，30例），分析两组的妊娠结局情况，对影响PPP的因素和MRI诊断价值进行分析。结果80例PP孕妇中，仅对照组中1例顺产；其中MRI诊断PP准确率为9375 %，MRI诊断胎盘粘连30例，准确率为8333 %，MRI诊断胎盘植入7例，准确率为5000 %，MRI诊断穿透2例，准确率为3333 %；观察组子宫切除率、产后出血量和输血量均明显高于对照组（P＜005）。Logistic回归分析结果显示，剖宫产次数（OR=1346）、人流史（OR=1525）是影响PP的独立危险因素(P<005)，MRI诊断胎盘植入的ROC曲线下面积为0814(P＜0 05)，灵敏度649 %和特异度833 %；MRI诊断胎盘粘连曲线下面积为0578，灵敏度465 %，特异度512 %；MRI诊断胎盘穿透曲线下面积为0614，灵敏度506 %，特异度527 %。结论MRI诊断可作为产前胎盘植入的早期诊断标准，有助于对不良妊娠结局进行有效预防。
Abstract:
ObjectiveTo evaluate magnetic resonance imaging(MRI) diagnostic value of pernicious placenta previa during pregnancy and its relationship with pregnancy outcome. MethodsRetrospective analyzed clinical data of 87 pregnant women in the third trimester suspected as placenta previa in Shenzhen Longgang Women and Children Health Care Hospital from March 2012 to June 2015.All underwent MRI examination while 80 cases were confirmed according to the results of surgery or pathology.Divided them into the observation group (50 cases of pernicious placenta previa) and the control group (30 cases of non-pernicious placenta previa). The pregnancy outcome of the two groups were analyzed. Factors affecting pernicious placenta previa and MRI diagnostic value were analyzed. ResultsAmong the 80 pregnant women with placenta previa, only 1 case in the control group underwent spontaneous abortion. The accuracy rate of MRI in diagnosis of placenta accreta was 9375%. MRI diagnosed placental adhesion were 30 cases, the accuracy rate was 8333%. Seven cases of placenta accreta were diagnosed by MRI with the accuracy of 5000%. Two cases of placenta perfusion were diagnosed by MRI with the accuracy of 3333%. The rate of hysterectomy, postpartum hemorrhage and blood transfusion in the observation group were significantly higher than those in the control group(P<005). Logistic regression analysis showed that the number of cesarean section(OR = 1346), the history of abortion(OR = 1525) were independent risk factors for placenta previa, the differences were statistically significant(P<005). The area under the ROC curve of MRI diagnosis of placenta accreta was 0814(P<005), the sensitivity was 64.9% and the specificity was 833%. The area under the curve of MRI in diagnosis of placenta accreta was 0578, the sensitivity was 465% and the specificity was 512%. The area under the curve of placenta penetration was 0614, the sensitivity was 506% and the specificity was 527%. ConclusionMRI diagnosis can be used as an early diagnostic criteria for prenatal placenta accreta and help to effectively prevent adverse pregnancy outcome.

参考文献/References:

［1］冯雪娜．欣母沛联合宫腔填纱治疗前置胎盘剖宫产产后出血的疗效 ［J］．中国生化药物杂志，2014，34（3）：147-148． ［2］刘金梅．前置胎盘的危险因素及护理对策 ［J］．河北中医，2012，34（6）：915-916． ［3］张晓霞．临床护理干预对前置胎盘围生期的影响分析 ［J］．实用医技杂志，2015,22（6）：670-671． ［4］刘兴会，姚强．凶险型前置胎盘的诊断及处理 ［J］．中国实用妇科与产科杂志，2011,27（2）：85-89． ［5］陈兢思．凶险型前置胎盘诊治进展 ［J］．现代妇产科进展，2012，21（9）：722-724, 728． ［6］周欣，张国英，孙丽洲，等．凶险型前置胎盘围术期综合手术治疗方法探讨 ［J］．实用妇产科杂志，2013，29（7）：516-518． ［7］艾文，刘雁，刘正平，等．彩超联合 MRI 诊断凶险型前置胎盘合并胎盘植入的价值 ［J］．广东医学，2016，37（z1）：42-44． ［8］刘湘萍，王竞，杨晓文，等．凶险型前置胎盘产前彩超和MRI诊断价值比较 ［J］．中国医药科学，2013，14（22）：10-11． ［9］侯倩男，常林利，周辉．凶险型前置胎盘中胎盘主体附着位置对母体预后的影响 ［J］．中华妇幼临床医学杂志(电子版)，2014，10（1）：83-86． ［10］龙新枝．凶险型前置胎盘33例临床分析 ［J］．广州医科大学学报，2016，44（3）：89-91． ［11］罗志丽，何景培．67例凶险型前置胎盘的临床特点分析 ［J］．国际医药卫生导报，2015，21（11）：1530-1532． ［12］谷豫鸣，魏俊，熊常君，等．超声检查与磁共振在植入性凶险型前置胎盘中的诊断价值 ［J］．中国医药导报，2016，13（4）：105-108． ［13］Crosara S, D'onofrio M, De Robertis R, et al Autoimmune pancreatitis: Multimodality non-invasive imaging diagnosis ［J］. World Journal of Gastroenterology, 2014, 20(45): 16881-16890. ［14］Craven I, Bradburn MJ, Griffiths PD. Antenatal diagnosis of agenesis of the corpus callosum ［J］. Clin Radiol, 2015, 70(3): 248-253. ［15］TAKUMA Kensuke, Kamisawa T, TABATA Taku, et al. Importance of early diagnosis of pancreaticobiliary maljunction without biliary dilatation ［J］. World J Gastroenterol, 2012, 18(26): 3409-3414.

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更新日期/Last Update: 2018-01-25