介入化学治疗联合米非司酮在妊娠中期胎盘前置状态引产中的应用  

Application of interventional chemotherapy combined with mifepristone in second trimester induction of labor with placenta previa

作　　者：李冰琳[1] 王文艳[1] 郭新贤[1] 

机构地区：[1]西安市中心医院妇产科,陕西西安710003

出　　处：《中国妇幼健康研究》2011年第5期693-694,共2页Chinese Journal of Woman and Child Health Research

摘　　要：目的 探讨经子宫动脉途径介入化学治疗配伍米非司酮在胎盘前置状态中期妊娠引产的可行性和临床疗效.方法 采用子宫动脉介入化疗术同时口服米非司酮对8例中期妊娠胎盘前置状态患者进行引产治疗.行超选择性子宫动脉内灌注氨甲蝶呤80mg,再用明胶海绵条（颗粒）栓塞子宫动脉,同时予以口服米非司酮以软化宫颈治疗,观察治疗效果及预后情况,并记录分析不良反应.结果 8例患者均栓塞成功,术后平均32h排出胎儿及附属物,无产后出血,产后10d内复查B超,均无宫腔残留,平均40d恢复月经.结论 经子宫动脉途径介入化学治疗配伍米非司酮用于胎盘前置状态中期妊娠引产安全有效、方法简单、不良反应小、成功率高,是行之有效的治疗方法.Objective To explore the feasibility and clinical therapeutic effect of uterine arterial interventional chemotherapy combined with mifepristone in second trimester induction of abortion with placenta previa. Methods Eight cases of second trimester pregnancy with placenta previa were treated with uterine arterial interventional chemotherapy and oral mifepristone to induce labor. Super-selective uterine arterial infusion was applied to infuse 80mg methotrexate, and gelatin sponge was used to embolize uterine artery. Meanwhile, mifepristone was administrated orally to intenerate cervix. The therapeutic effect and prognosis were observed and adverse reaction was recorded and analyzed. Results The uterine artery of 8 cases was embolized successfully, and the average time of labor after the procedure was 32h, without postpartum hemorrhage. There was no residual in uterine cavity examined by Color Doppler ultrasound 10 days after that. The average time of return of normal menses was 40 days. Conclusion Uterine arterial interventional chemotherapy combined with mifepristone in second trimester induction abortion with placenta previa is safe, effective and convenient with high success rate. The adverse effect is mild.

关 键 词：中期妊娠 胎盘前置状态 介入化学治疗 氨甲蝶呤 米非司酮 

分 类 号：R691.3[医药卫生—泌尿科学] R173[医药卫生—外科学]