彩超产前诊断前置胎盘并发胎盘植入的价值（附228例前置胎盘病例分析）

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1、彩超产前诊断前置胎盘井发胎盘植入的价值(附228例前置胎盘病例分析)研究生:李萍导师:刘兴会教授指导老师:张力主治医师游泳副教授摘要目的:探讨前置胎盘及前置胎盘并发胎盘粘连或植入的临床特点及围生期处理;并评估彩色多普勒超声诊断前置胎盘并发胎盘植入的价值。方法:回顾性分析2000年1月一2003年12月在四川大学华西二院最终确诊为前置胎盘的228例患者的临床资料;并对2002年6月~-2003年12月在该院经产前彩色超声多普勒诊断的19例前置胎盘患者进行跟踪调查。结果:①前置胎盘易并发胎盘粘连或植入，孕妇年龄越大、流产次数越多，并发胎盘粘连或植入的机率越大(P<0.05)

2、;且并发胎盘粘连或植入使产时出血量大大增加(p<0.01)o②彩超产前诊断前置胎盘并发胎盘植入的阳性预测值为70.0%，阴性预测值为88.89，有临床运用价值。结论:前置胎盘并发胎盘粘连或植入对终止妊娠时母儿的生命安全威胁巨大，彩超产前诊断前置胎盘并发胎盘植入有一定准确性，能够有效指导临床工作，降低因不可预见的产时大出血而导致的母儿死亡。关键词:前置胎盘、胎盘植入、彩色超声多普勒ThevalueofthecolorDopplerultrasoundinthediagnosisofplacentapreviawithplacentaaccreta/increta/perc

3、reta(Appendix:Analysisofthe228cliniccasesofplacentaprevia)Postgratuate:LiPingTutor:LiuXinghuiMemberofdirectiongroup:ZhangLiYouYongAbstractObjective:Discussthecliniccharacterandperinatalperioddisposalofplacentapreviawithplacentaadhesion,accretaincretaandpercreta.Andassessingthevalueofthec

4、olorDopplerultrasoundinthediagnosiso#placentapreviawithplacentaaccreta/increta/percreta.Method:Retrospectivlyanalyzingthe228cliniccaseswhichwereultimatelydiagnosedplacentapreviainthe2"dhospitalofSiChuanuniversityfromJantoDee2003.Andtracingthe19prenatalpatientswhowerediagnosedplacentaprev

5、iabycolorDopplerultrasoundimigeinthe2"dhospitalofSiChuanuniversityfromJune2002toDecember2003.Result:①Placentaadhesionandplacentaaccreta/increta/percretaarerelatedtotheageandtheabortivefrequencyofthepregnantpatient(p<0.05),andtheyarestronglyrelatedtotheamountofhemrrohage.②Byusingtheprenat

6、alcolorDopplerultrasoundimigetodiagnosetheplacentapreviawithplacentaaccreta/increta/percreta,thepositivepredictivevalueis70.0%;thenegativepredictivevalueis88.89%.Itcanbeusedtoguidetheclinicwork.Conclusion:Placentaprevioradhesion,accreta/increta/percretaarerelatedtotheageandtheabortivefre

7、quencyofthepregnantpatient.Theyarecloselyaffecttheamountofhemrrohagewhileterminatingthepregnancy.Thusthreatenthesecurityofthemotherandthefetus.UsingtheprenatalcolorDopplerultrasoundimigecanguidetheclinicworktoinducethedeathofthemotherandthefetusbyinducetheunpredictivelybl