宫腔镜电切联合球囊、MTX联合米非司酮治疗部分性胎盘植入的优劣差异  

The comparison the differences of hysteroscopic electrosection combined with balloon and MTX combined with mifepristone in the treatment of partial placenta accreta

作　　者：张艳萍 ZHANG Yanping(Department of Gynaecology,Tongren Gynecological Hospital of Shenzhen,Shenzhen 518000,China)

机构地区：[1]深圳同仁妇科医院妇科,广东深圳518000

出　　处：《中国医药科学》2018年第6期74-77,共4页China Medicine And Pharmacy

摘　　要：目的比较宫腔镜电切联合球囊、MTX联合米非司酮对部分性胎盘植入患者的疗效优劣差异。方法选择2014年4月~2015年12月我院接诊的50名中孕引产后部分性胎盘植入的患者,按随机抽取住院号的方式分为对照组和实验组,每组各25例,对照组患者采用MTX联合米非司酮方法临床治疗,实验组患者采用宫腔镜电切联合球囊方法临床治疗。观察两组患者住院费用、血人绒毛膜促性腺激素(HCG)恢复正常时间、阴道流血持续时间、住院时间、胎盘组织排出时间、感染率、治愈率、清宫率以及子宫复旧情况。结果实验组患者的住院费用高于对照组,差异有统计学意义(P<0.05);但是实验组患者的血HCG降至正常所需时间、阴道流血持续时间等指标均少于对照组,差异有统计学意义(P<0.05);治疗前,两组患者的β-HCG、孕酮、FSH水平均差异无统计学意义(P>0.05),治疗后,两组患者的β-HCG、孕酮、FSH等水平均与治疗前比较有所改善,且实验组患者的改善情况明显优于对照组,差异有统计学意义(P<0.05),两组均能保守治疗成功,感染发生率差异无统计学意义(P>0.05);清宫率、子宫复旧情况组间差异比较有统计学意义(P<0.05);观察组患者出现的恶心、呕吐、口腔溃疡等不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。结论腔镜电切联合球囊、MTX联合米非司酮两种方法对部分性胎盘植入患者治疗效果显著,而宫腔镜电切联合球囊不良反应少,复发率低,适合临床推广。Objective To study the differences of hysteroscopic electrosection combined with balloon and MTX combined with mifepristone in the treatment of partial placenta accrete.Methods From April 2014 to December 2015,50 patients with partial placenta accreta after induction of labor in our hospital were selected.The number of hospitalized patients was randomly divided into control group and experimental group,25 cases in each group.The control group was treated with MTX combined with mifepristone.The patients in the experimental group were treated by hysteroscopic resection combined with balloon therapy.The hospitalization expenses,blood human chorionic gonadotropin(HCG)recovery time,vaginal bleeding duration,hospitalization time,placental tissue discharge time,infection rate,cure rate,palace rate and uterine involution were observed in the two groups of patients.Results The hospitalization cost of the experimental group was higher than that of the control group,the difference was statistically significant(P<0.05).However,the time of blood HCG to normal and the duration of vaginal bleeding in the experimental group were all less than those in the control group,the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the levels ofβ-HCG,progesterone and FSH between the two groups(P>0.05).After treatment,the levels ofβ-HCG,progesterone and FSH in the two groups were improved compared with those before treatment,the improvement of the patients in the experimental group was significantly better than that in the control group(P<0.05).The two groups were able to succeed in conservative treatment.There was no significant difference in the incidence of infection(P>0.05).The rate of curettage,uterine involution difference between the groups was statistically significant(P<0.01).The incidence of adverse reactions such as nausea,vomiting and oral ulcers in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Two methods of endoscopic re

关 键 词：MTX 米非司酮 宫腔镜电切 球囊 部分性胎盘植入 

分 类 号：R714.462[医药卫生—妇产科学]