西部中医药
西部中醫藥
서부중의약
GANSU JOURNAL OF TRADITIONAL CHINESE MEDICINE
2013年
8期
98-100
,共3页
中期引产%胎盘植入%中西医结合
中期引產%胎盤植入%中西醫結閤
중기인산%태반식입%중서의결합
induced labor in midpregnancy%placenta accrete%integrative medicine
目的：探讨中期引产后保守治疗胎盘植入的方法。方法：将80例中期引产后胎盘植入的患者分为2组，对照组36例单次肌肉注射甲氨蝶呤加米非司酮，治疗组44例在对照组治疗的基础上口服协定“胎盘植入”中药处方治疗。2组均于治疗前、治疗后1、2、3周检测血清中β-HCG水平，并同期采用B超测量胎盘范围以评价治疗效果。结果：治疗组总有效率为93.18%，41例患者免行清宫术及宫腔镜下切除术；对照组总有效率为33.33%，实施清宫术者20例，行宫腔镜下切除者3例、子宫全切者1例，2组相比差异有统计学意义；治疗1周及2周后2组血清β-HCG值均较前次检查结果明显下降(P＜0.01)，超声提示宫腔内残留胎盘组织面积也较前次检查结果明显缩小(P＜0.01)，2组血清β-HCG 值及宫腔残留面积比较，差异有统计学意义(P＜0.01)。结论：单次肌肉注射甲氨蝶呤加米非司酮联合“胎盘植入”协定中药处方治疗胎盘植入疗效好。
目的：探討中期引產後保守治療胎盤植入的方法。方法：將80例中期引產後胎盤植入的患者分為2組，對照組36例單次肌肉註射甲氨蝶呤加米非司酮，治療組44例在對照組治療的基礎上口服協定“胎盤植入”中藥處方治療。2組均于治療前、治療後1、2、3週檢測血清中β-HCG水平，併同期採用B超測量胎盤範圍以評價治療效果。結果：治療組總有效率為93.18%，41例患者免行清宮術及宮腔鏡下切除術；對照組總有效率為33.33%，實施清宮術者20例，行宮腔鏡下切除者3例、子宮全切者1例，2組相比差異有統計學意義；治療1週及2週後2組血清β-HCG值均較前次檢查結果明顯下降(P＜0.01)，超聲提示宮腔內殘留胎盤組織麵積也較前次檢查結果明顯縮小(P＜0.01)，2組血清β-HCG 值及宮腔殘留麵積比較，差異有統計學意義(P＜0.01)。結論：單次肌肉註射甲氨蝶呤加米非司酮聯閤“胎盤植入”協定中藥處方治療胎盤植入療效好。
목적：탐토중기인산후보수치료태반식입적방법。방법：장80례중기인산후태반식입적환자분위2조，대조조36례단차기육주사갑안접령가미비사동，치료조44례재대조조치료적기출상구복협정“태반식입”중약처방치료。2조균우치료전、치료후1、2、3주검측혈청중β-HCG수평，병동기채용B초측량태반범위이평개치료효과。결과：치료조총유효솔위93.18%，41례환자면행청궁술급궁강경하절제술；대조조총유효솔위33.33%，실시청궁술자20례，행궁강경하절제자3례、자궁전절자1례，2조상비차이유통계학의의；치료1주급2주후2조혈청β-HCG치균교전차검사결과명현하강(P＜0.01)，초성제시궁강내잔류태반조직면적야교전차검사결과명현축소(P＜0.01)，2조혈청β-HCG 치급궁강잔류면적비교，차이유통계학의의(P＜0.01)。결론：단차기육주사갑안접령가미비사동연합“태반식입”협정중약처방치료태반식입료효호。
Objective: To find the conservative method of treating placenta accreta after terminating the mid-term gestation. Method:Eighty patients were allocated into 36 cases in the control group and 44 cases in the treatment group. The control group received single intramuscular injection of methotrexate and mifepristone, the treatment group took the prescriptions against placenta accreta, the level ofβ-HCG in the serum was detected before treating and at the 1st, 2nd and 3rd week after treating, meanwhile placental range was measured with type-B ultra-sonic to assess curative effects. Result:Total effective rate of the treatment group was 93.18%, there were 41 patients without complete curettage of uterine cavity and hysteroscopic resection;total effective rate of the control group was 33.33%, 20 patients were performed complete curettage of uterine cavity, three cases with hysteroscopic resection, one case with complete resection of the uterine, the difference had statistical meaning between both groups;serumβ-HCG was decreased significantly in one week and two weeks after treating compared with the former examination (P<0.01), the results of B ultrasonic revealed that the area of residual placental tissue was shrinking than the former examination (P<0.01), the difference had statistical meaning in the comparison of β-HCG and residual areas of uter-ine cavity (P<0.01). Conclusion:Single intramuscular injection of methotrexate and mifepristone combined with the prescriptions are effective for placenta accrete.
