CAJ | 학술논문

探讨胎儿心腔注射氯化钾在中晚期妊娠合并前置胎盘患者引产中的临床效果。方法选取重庆市万州区妇幼保健院2011年2月至2013年12月间收治的中晚期妊娠合并前置胎盘患者60例的临床资料，按不同处理方式分为观察组和对照组各30例。对照组患者在引产前1天口服米非司酮300 mg，并向羊膜腔内注射利凡诺尔100 mg；观察组患者在此基础上在B超引导下向胎儿心腔内注射10％氯化钾。比较两组患者的总产程、分娩时出血量、剖宫取胎、子宫切除、胎盘残留（胎盘植入）、清宫以及不良反应发生情况。结果两组患者总产程、胎盘残留及清宫率、不良反应发生率比较，差异无统计学意义（ P＞0.05）；观察组患者分娩时出血量（386±204）mL、剖宫取胎率（0）、子宫切除率（0）低于对照组[分别为（701±315） mL、26.7％、13.3％]（ P＜0.05）。结论在中晚期妊娠合并前置胎盘患者引产中采用胎儿心腔注射氯化钾可有效减少患者分娩时出血量及剖宫取胎率，具有操作简单、安全有效、不良反应少等优点。
탐토태인심강주사록화갑재중만기임신합병전치태반환자인산중적림상효과。방법선취중경시만주구부유보건원2011년2월지2013년12월간수치적중만기임신합병전치태반환자60례적림상자료，안불동처리방식분위관찰조화대조조각30례。대조조환자재인산전1천구복미비사동300 mg，병향양막강내주사리범낙이100 mg；관찰조환자재차기출상재B초인도하향태인심강내주사10％록화갑。비교량조환자적총산정、분면시출혈량、부궁취태、자궁절제、태반잔류（태반식입）、청궁이급불량반응발생정황。결과량조환자총산정、태반잔류급청궁솔、불량반응발생솔비교，차이무통계학의의（ P＞0.05）；관찰조환자분면시출혈량（386±204）mL、부궁취태솔（0）、자궁절제솔（0）저우대조조[분별위（701±315） mL、26.7％、13.3％]（ P＜0.05）。결론재중만기임신합병전치태반환자인산중채용태인심강주사록화갑가유효감소환자분면시출혈량급부궁취태솔，구유조작간단、안전유효、불량반응소등우점。
Objective To investigate the clinical effect of pregnancy termination of women with placenta previa in the middle and late pregnancy by intracardiac injection of potassium chloride .Methods Data of 60 patients with placental previa in the middle and late pregnancy treated in Maternal and Child Health Hospital of Wanzhou District from Feb 2011 to Dec 2013 were selected, all cases were divided into observation group and control group according to different treatments with 30 cases in each group .Patients in control group were given oral Mifepristone 300 mg and amniotic cavity injection of Rivanol 100 mg 1 day before induction .Patients in observation group also received fetal intracardiac injection 10% of potassium chloride under the guidance of B ultrasound .The total stage of labor , postpartum bleeding , the number of cases of cesarean birth and hysterectomy , residue placenta ( placenta implantation ) , curettage and adverse reactions were compared between the two groups .Results The differences were not statistically significant in the total stage of labor , residual placenta , curettage and adverse reactions between two groups ( P >0.05 ) .The postpartum bleeding[(386 ±204)mL],occurrence of caesarean birth(0),occurrence of uterine resection(0) of observation group were lower than that of control group[(701 ±315)mL, 26.7%,13.3%](P<0.05).Conclusion Pregnancy termination of women with placenta previa the middle and late pregnancy by intracardiac injection of potassium chloride can effectively reduce the amount of bleeding and cesarean cases .This method has the advantages of simple operation , safety and efficiency and less adverse reaction .