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目的:观察凶险型前置胎盘患者的临床特点及对妊娠结局的影响。方法:选择凶险型前置胎盘26例为观察组,另选择普通型前置胎盘36例为对照组,比较两组年龄、孕产史、产时和产后情况及新生儿情况等。结果:两组年龄、孕产次、分娩孕周及产前出血发生率等比较,均差异显著或非常显著(P<0.05,P<0.01)。观察组手术时间、术中出血量均显著长于或多于对照组(P<0.05),术中和术后输血、胎盘植入、子宫切除及产后出血等的发生率,均显著或非常显著高于对照组(P<0.05,P<0.01)。对于产后出血的处理,两组在B-Lynch缝合的选择上差异不显著(P>0.05);而在介入治疗和子宫切除的选择上,则差异显著(P<0.05)。观察组新生儿出生体质量、1min Apgar评分,均显著低于对照组(P<0.05);早产儿、新生儿窒息发生率比较,均显著或非常显著高于对照组(P<0.05,P<0.01)。结论:凶险型前置胎盘具有不同于普通型的显著特点,可对妊娠结局产生严重不良影响,临床应给予高度重视。
Objective: To observe the clinical characteristics of patients with dangerous placenta previa and its effect on pregnancy outcome. Methods: Sixty-six cases of dangerous placenta previa were selected as the observation group. Another 36 cases of common placenta previa were selected as the control group. The age, maternal history, postnatal and postpartum period, neonatal condition and so on were compared. Results: There were significant differences between two groups (P <0.05, P <0.01) in terms of age, gestational age, gestational age of childbirth and the incidence of prenatal hemorrhage. The operation time and intraoperative blood loss in the observation group were significantly longer than or more than those in the control group (P <0.05). The incidence of intraoperative and postoperative blood transfusion, placenta accreta, hysterectomy and postpartum hemorrhage were all significantly or very significantly higher In the control group (P <0.05, P <0.01). For the treatment of postpartum hemorrhage, there was no significant difference between the two groups in the selection of B-Lynch sutures (P> 0.05), but in the choice of interventional therapy and hysterectomy (P <0.05). The neonatal birth weight and 1-minute Apgar score in the observation group were significantly lower than those in the control group (P <0.05). The incidence of asphyxia in preterm infants and newborns was significantly or very significantly higher than that in the control group (P <0.05, P < 0.01). Conclusion: The plague of placenta previa has different characteristics from the common type, which can have serious adverse effects on pregnancy outcome. Clinical should be given high priority.