目的：探讨胎盘早剥并发子宫胎盘卒中的诱发因素、临床特点及母儿结局。方法回顾性分析河北省沧州市中心医院收治的89例胎盘早剥患者，将患者按是否并发子宫胎盘卒中分为两组：胎盘早剥并发子宫胎盘卒中40例为观察组；余49例作为对照组。结果重度子痫前期是胎盘早剥并发子宫胎盘卒中的重要高危因素之一，两组最主要的诱发因素均为重度子痫前期（χ2＝7．45，P＜0．01）。子宫胎盘卒中患者的就诊时限长于对照组[分别为364．0（270．0～482．0）min和198．0（93．8～214．5） min；Z＝7．52，P＜0．01]。观察组中重型胎盘早剥、胎盘附着于宫角部、产后出血、新生儿1分钟Apgar评分＜7的发生率均高于对照组（χ2值分别为37．70、7．36、9．61、12．24，均P＜0．05）。结论子宫胎盘卒中反映了胎盘早剥的严重程度，与母儿结局关系密切，尽早确诊并治疗可以改善母儿结局。%Objective To investigate the predisposing factors , clinical characteristics , and maternal and fetal outcomes of cases of placental abruption complicated by uteroplacental apoplexy .Methods A retrospective analysis was conducted on 89 cases of placental abruption admitted in Cangzhou Central Hospital .Among those , 40 cases complicating with uteroplacental apoplexy were included in observation group, and the other 49 cases without uteroplacental apoplexy were in control group .Results Severe pre-eclampsia was one of the high-risk factors of placental abruption complicated by uteroplacental apoplexy .The most important induced factor was severe preeclampsia (χ2 =7.45, P<0.01).Treatment time of patients complicated by uteroplacental apoplexy was longer than that of control group [364.0(270.0-482.0)min and 198.0(93.8-214.5) min, Z =7.52, P <0.01].In the observation group, the incidence rates of severe placental abruption, placenta attaching to the uterine corneal , postpartum hemorrhage , and neonatal 1 minute Apgar score <7 were higher than the control group (χ2 value was 37.70, 7.36, 9.61 and 12.24, respectively, all P<0.05).Conclusion Uteroplacental apoplexy reflects the severity of placental abruption , and it is closely related with maternal and fetal outcomes .Diagnosis and treatment as early as possible can improve the outcomes of mother and fetus .
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