凶险型前置胎盘128例临床分析
Clinical analysis of 128 cases of pernicious placenta previa.
目的 探讨凶险型前置胎盘的临床特点。方法 回顾性分析中国医科大学附属盛京医院产科2009年8月至2014年8月收治的128例凶险型前置胎盘患者（观察组）与384例普通型前置胎盘患者（对照组）的临床资料，并进行比较。结果 观察组发生胎盘粘连（22.6%）、胎盘植入（44.5%）、子宫切除（20.3%）、产后出血（51.6%）及输血（42.2%）的比例明显高于对照组（分别为16.7%、5.2%、1.8%、11.7%、4.9%），差异有统计学意义（P<0.05）。两组新生儿结局比较，观察组早产儿发生率（53.9%）明显高于对照组（39.3%），差异有统计学意义（P<0.05）。结论 凶险型前置胎盘严重威胁母儿生命安全，严格掌握剖宫产指征，降低剖宫产率，是减少凶险型前置胎盘发生的关键环节。
Abstract： Objective To investigate the clinical characteristics of pernicious placenta previa during pregnancy，and to improve the understanding of pernicious placenta previa and accumulate clinical management experience.Methods A retrospective analysis was done in 128 cases of pernicious placenta previa (observation group)and 384 cases of normal placenta previa (control group) in Shengjing Hospital affiliated to China Medical University from August 2009 to August 2014.Results In the observation group,the incidence of placental adherence（22.6%），placenta accreta（44.5%），hysterectomy（20.3%），and transfusion of postpartum hemorrhage（42.2%） were apparently higher those that of control group，the difference being statistically significant (P<0.05).Comparison of two groups on neonatal outcome showed statistical significance (P<0.05) in premature infants.Conclusion Pernicious placenta previa seriously threatens maternal and fetal life.Strictly grasping the indications for cesarean section and reducing the rate of cesarean section is the key to reducing the number of pernicious placenta previa.
pernicious placenta previa / postpartum hemorrhage / cesarean section
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（2015-01-06收稿 2015-03-18修回）
国家自然科学基金（81300492）
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