胎盘早剥49例临床分析及早期诊断方法的探讨

目的:通过对胎盘早剥的临床分析,探讨胎盘早剥的早期诊断方法。方法:回顾性分析49例胎盘早剥的临床资料。结果:胎盘早剥发生率为0.58%,轻型36例,占73.4%,重型13例,占26.5%,无诱因的33例,占67.34%。产前确诊率为48.98%,误诊率为51.02%;尤其轻型胎盘早剥产前误诊率高达61.11%,轻型胎盘早剥B超阳性检出率只有38.88%,而重型胎盘早剥B超阳性检出率占55.46%,但误诊率仍达15.4%。结论:胎盘早剥发生多无明显诱因,大多临床表现隐匿,B超诊断胎盘早剥虽然是一种重要辅助手段,但仍存在一定的局限性,其诊断应由临床医生提高警惕,把握患者细微的变化,根据病史、临床症状和体征,结合B超以及电子胎心监护早期诊断及处理,方可降低母儿不良事件的发生。

Clinical analysis of 49 cases with placental abruption and investigation of the method of early clinical diagnosis

Objective Through clinical analysis of placental abruption,explore the method of early diagnosis of placental abruption.Methods A retrospective analysis of 49 cases of placental abruption clinical data.Results Placental abruption occurred at a rate of 0.58%,light in 36 cases,accounting for 73.4%,13 cases of severe,accounted for 26.5% of the 33 cases,no cause,accounted for 67.34%.Prenatal diagnosis rate was 48.98%,the misdiagnosis rate was 51.02%;in particular,light placental abruption prenatal misdiagnosis rate reaches as high as 61.11%,light placental abruption B ultrasound positive rate of only 38.88%,and severe placental abruption B ultrasound positive rate was 55.46%,but the rate of misdiagnosis is 15.4%.Conclusion Placental abruption occurred without apparent cause,most clinical manifestation of occult,B ultrasound diagnosis of placental abruption is an important auxiliary means,but there are still some limitations,its diagnosis by clinicians to improve vigilance,grasp the subtle changes in patients,based on history,clinical signs and symptoms,combined with B ultrasound and electronic fetal heart monitoring in early diagnosis and treatment,may reduce maternal and fetal adverse events.