米非司酮联合甲氨蝶呤治疗胎盘植入的临床效果.docVIP

米非司酮联合甲氨蝶呤治疗胎盘植入的临床效果 　　[摘要]目的 探讨米非司酮联合甲氨蝶呤治疗胎盘植入的临床效果。方法 选择2012年3月～2015年12月于我院就诊的58例胎盘植入患者，将其简单随机分为观察组（29例）和对照组（29例），对照组患者单纯采用甲氨蝶呤治疗，观察组患者则联合使用米非司酮治疗。观察两组患者的治疗效果，治疗前后血β-HCG、血孕酮及卵巢激素的变化情况，胎盘排出时间、血β-HCG转阴和阴道出血停止时间以及用药后的不良反应情况。结果 观察组的治疗有效率为96.55%（28/29），对照组的治疗有效率为79.31%（23/29），两组比较差异有统计学意义（P0.05）；治疗后两组患者的血β-HCG和孕酮显著降低，LH、FSH、E2水平逐渐恢复（均P0.05）。结论 米非司酮联合甲氨蝶呤较单纯甲氨蝶呤治疗胎盘植入效果更佳，对性激素的改善效果好，早期止血效果佳，不良反应发生率未升高。 　　[关键词]米非司酮；甲氨蝶呤；胎盘植入；安全性 　　[中图分类号] R714.2 [文献标识码] A [文章编号] 1674-4721（2016）10（c）-0137-03 　　[Abstract]Objective To investigate the clinical efficacy of Mifepristone combined with Methotrexate in the treatment of placenta implantation.Methods 58 patients with placenta implantation in our hospital from March 2012 to December 2015 were selected and randomly divided into the observation group （n=29） and the control group （n=29）.The patients in the control group were treated with Methotrexate alone，and the patients in the observation group were treated with Mifepristone combined with Methotrexate.The efficacy，changes of β-HCG，progesterone and ovarian hormone，and placental discharge time before and after the treatment，blood β-HCG negative time and vaginal bleeding stop time，as well as the adverse reactions after treatment were observed.Results The effective rate was 96.55% （28/29） in the observation group and 79.31% （23/29） in the control group，and the difference was statistically significant（P0.05）.After treatment，the levels of β-HCG and progesterone of the two groups were significantly decreased，and hormone levels of LH， FSH and E2 were gradually recovered （all P0.05）. Conclusion Mifepristone combined with Methotrexate is more effective than Methotrexate alone in the treatment of placenta implantation.The improvement effect of sex hormones is good in early hemostasis，and no significant elevations of adverse reactions are observed. 　　[Key words]Mifepristone；Methotrexate；Placenta implantation；Safety 　　胎盘植入是妇产科较为常见的疾病，近年来随着人工流产，剖宫产，引产等的增多，胎盘植入的发病率也呈上升趋势[1]。胎盘植入病情凶险，早期