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目的:通过回顾性分析凶险型前置胎盘的临床资料,探讨凶险型前置胎盘的临床处理对策。方法:收集近5年来本院收治的前置胎盘患者的临床资料,对来不及转诊33例凶险型前置胎盘与72例普通型前置胎盘产妇的临床资料进行分析比较。结果:凶险型前置胎盘组与普通型前置胎盘组在产前出血发生的孕周、剖宫产术中出血量、DIC发生率、胎盘植入率、子宫切除率、输血率方面的比较差异有统计学意义(P<0.05),围生儿结局方面差异无统计学意义(P>0.05)。结论:凶险型前置胎盘难治性产后出血发生率、胎盘植入率、DIC发生率、子宫切除率高,严重威胁孕产妇生命安全。应高度重视凶险型前置胎盘的诊断,对早孕期诊断的子宫下段瘢痕部位妊娠应及时终止妊娠;对妊娠晚期的凶险型前置胎盘应做好转诊及各种抢救预案,尽可能地降低对孕产妇可能造成的危害。
Objective: To retrospectively analyze the clinical data of dangerous placenta previa and discuss the clinical treatment strategies of dangerous placenta previa. Methods: The clinical data of patients with placenta previa admitted in our hospital in the past 5 years were collected. The clinical data of 33 cases of threatened placenta previa and 72 cases of common placenta previa were analyzed before and after treatment. Results: Comparison of gestational age, bleeding in cesarean section, incidence of DIC, placenta accreta, hysterectomy, and blood transfusion in the precarious placenta group and the general placenta previa group The difference was statistically significant (P <0.05), there was no significant difference in perinatal outcome (P> 0.05). Conclusions: The incidence of intractable postpartum hemorrhage, placenta accreta, DIC and hysterectomy rate in threatening placenta previa is a serious threat to maternal life safety. Should pay great attention to the diagnosis of dangerous placenta previa, early pregnancy diagnosis of uterine scar pregnancy should promptly terminate the pregnancy; late pregnant placenta previa should be a referral and rescue plan, as much as possible to reduce Possible harm to pregnant women.