[1]周新娥,梅又文,程薇,等.胎盘早剥并发产后出血的危险因素及围产结局分析[J].中国计划生育和妇产科,2017,(12):13-17.
　ZHOU Xin-e,MEI You-wen,CHENG Wei,et al.Analysis of risk factors and perinatal outcomes of placental abruption complicated with postpartum hemorrhage[J].Chinese Journal of Family Planning & Gynecotokology,2017,(12):13-17.
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胎盘早剥并发产后出血的危险因素及围产结局分析
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2017年12期
页码:
13-17
栏目:
论著与临床
出版日期:
2017-12-25

文章信息/Info

Title:
Analysis of risk factors and perinatal outcomes of placental abruption complicated with postpartum hemorrhage
作者:
周新娥1; 梅又文1; 程薇1; 王利民1; 高岚1*; 魏桂花2
1.610091四川成都，成都市妇女儿童中心医院产科；2.610031四川成都，西南交通大学生命科学与工程学院
Author(s):
ZHOU Xin-e1;  MEI You-wen1;  CHENG Wei1;  WANG Li-min1; GAO Lan1*; WEI Gui-hua2
1.Department of Obstetrics, Chengdu Women and Children’s Central Hospital, Chengdu Sichuan 610091,P.R.China;2.School of Life and Engineering, Southwest Jiaotong University, Chengdu Sichuan 610031,P.R.China
关键词:
胎盘早剥; 产后出血; 危险因素
Keywords:
placental abruption;  postpartum hemorrhage;  risk factors
分类号:
R 71456
摘要:
目的探讨胎盘早剥患者产后出血的危险因素。方法回顾性分析2012~2016年于成都市妇女儿童中心医院住院分娩的278例胎盘早剥并行剖宫产术患者的临床资料，将胎盘早剥并发产后出血95例设为研究组，未并发产后出血的183例为对照组，比较两组一般情况、临床特征、发病危险因素及母儿结局。结果① 两组患者的年龄、孕次、产次、体质量指数比较，差异无统计学意义(P>005);② 研究组患者术前阴道流血率、持续性腹痛率、子宫张力高压痛率及胎监异常率高于对照组 (P<005),两组血性羊水率、B超检查异常率比较差异无统计学意义(P>005);③ 单因素分析显示，研究组早产发生率、子痫前期发生率、绒毛膜羊膜炎的发病率、胎盘位于后壁率及发病持续时间高于对照组(P<005),而甲状腺功能减退率、胎儿生长受限率、胎膜早破率、机械因素率及胎儿性别比例比较差异无统计学意义(P＞005)；二元Logistic回归分析发现早产、子痫前期及发病持续时间是胎盘早剥患者发生产后出血的独立危险因素;④ 研究组母体子宫卒中率、弥散性血管内凝血（disseminated intravascular coagulation,DIC）发生率、子宫切除率、新生儿窒息率、新生儿死亡率均高于对照组(P<005)。结论早产、子痫前期及发病持续时间长是胎盘早剥发生产后出血的独立危险因素，临床上应高度重视，以改善母儿预后。
Abstract:
ObjectiveTo investigate the risk factors of placental abruption with postpartum hemorrhage. Methods278 cases of placenta abruption performed with cesarean section were collected from 2012 to 2016 in Chengdu Women and Children's Central Hospital. The cases were divided into two groups: 95 cases complicated with postpartum hemorrhage were the observation group, 183 cases without postpartum hemorrhage were the control group. Retrospective analysis was used to analyze the clinical features, risk factors and maternal-fetal outcomes in both groups. Results① There were no significant differences between the two groups in age,gravidity,parity and birth weight index(P>0.05)；② The incidences of vaginal bleeding, persistent abdominal pain, high uterine tension and abnormal fetal monitoring rate in the study group were higher than that in the control group(P<0.05). There were no significant differences in the rate of bloody amniotic fluid and abnormal B-ultrasonic examination(P>0.05)；③ Single factor analysis showed:the rates of preterm delivery, preeclampsia, chorioamnionitis, posterior placenta location and time interval between symptom onset and C-section in the study group were higher than that in the control group(P<0.05).However, the rates of hypothyroidism, fetal growth restriction, premature rupture of membranes and fetal sex were not different between the two groups(P＞0.05). Logistic regression analysis revealed that preterm delivery, preeclampsia and time interval between symptom onset and C-section were independent factors of postpartum hemorrhage in patients with placental abruption.④ The rate of neonatal asphyxia, neonatal death, uterine apoplexy, disseminated intravascular coagulation and hysterectomy was higher in the study group than that in the control group. ConclusionPreterm delivery, preeclampsia and time interval between symptom onset and C-section are independent risk factors of postpartum hemorrhage. More attention should be paid to the risk factors of postpartum hemorrhage in placental abruption to improve maternal and fetal outcomes.

参考文献/References:

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备注/Memo

备注/Memo:
成都市卫生局科研课题（项目编号：2014061）；中央高校基本科研业务费专项资金资助（项目编号：2682016CX103）
更新日期/Last Update: 2017-12-25