胎盘植入22例保守治疗研究.docVIP

胎盘植入22例保守治疗研究 　　[中图分类号]R681[文献标识码]B 【文章编号】1672-3783(2010)07-0007-02 　　【摘要】: 目的 研究通过不同方法及药物保守治疗胎盘植入成功率的比较。方法 我院对于1996-2009年间22例胎盘植入患者分别予以观察组:甲氨喋呤+米非司酮保守治疗。对照组:甲氨喋呤保守治疗。结果 观察组治疗效果显著有效率达75%,对照组达60%,2组比较差异有极显著意义。结论 联合使用甲氨喋呤+米非司酮保守治疗成功率明显大于单用甲氨喋呤,明显提高了保守治疗的成功率,减少了行子宫切除术的比率,大大保留了年轻患者的子宫。 　　【关键字】:胎盘植入 甲氨喋呤 米非司酮 保守治疗 　　The research into 22 cases of placenta accreta with conservative treatment 　　Xiao-Yan Li, Obstetrics and Gynecolog Guangan District Chinese Medicine Hospital#8239; Guangan City, Sichuan Province Post Code: 638,000 　　【Abstract】 Objective To study the comparison of the success rate of placenta accrete with conservative treatment through different methods and drugs.#8239; MethodsIn the years 1996-2009, there were 22 cases of placenta accrete classified into 2 groups in our hospital--- observation group and control group. For the first group, they were carried out conservative treatment with Methotrexate and Mifepristone, 　　while the other are conducted conservative treatment with Methotrexate.Results There is a significant therapeutic effect?on observation group with the success rate of 75%. While control group accounts for 60%. Therefore the comparison is of great significance.ConclusionThe success rate of conservative treatment with Joint use of methotrexate,and mifepristone is significantly larger than methotrexate alone, which greatly improved the success rate of conservative treatment, reduced the rate of hysterectomy, and retained the young patients uterus#8239; 　　【Keywords】#8239; Placenta Accreta #8239; Methotrexate#8239; #8239;Mifepristone #8239;Conservative Treatment - 　　 　　 　　1 #8239; 资料与方法 　　1.1 一般资料 我院对1996年4月-2009年9月在我院行剖宫产及分娩发现胎盘植入22例的患者,诊断主要依靠临床检查和术中发现:临床上对产后半小时胎盘不下, 宫腔探查及人工剥离胎盘不能娩出胎盘组织或娩出不完整者进行彩超、CT等检查进一步确诊。就22例探讨胎盘植入的保守治疗。随机分成两组:观察组12人:要求使用甲氨喋呤+米非司酮保守治疗 对照组10人:要求使用甲氨喋呤保守治疗。两组年龄、孕产次、孕龄均无统计学意义。治疗前均必须具备以下条件:产妇迫切希望保留生育功能者;无明显阴道流血或流血不多, 无感染迹象, 生命体征稳定, 血红蛋白 90 g/L, 凝血功能. 肝肾功能正常;胎盘植入面积小于宫腔面积的1 /2;胎盘着床在子宫下段以上;无药物禁忌;有及时输血的条件及设备;具有高效的抗生素作为抗感染