超声引导下平阳霉素治疗胎盘植入的疗效分析  

Efficacy of ultrasound-guided pingyangmycin sclerotherapy in treatment of placental implantation

作　　者：赵军凤[1] 钱林学[1] 谭小蕖[1] 刘玉江[1] Zhao Junfeng;Qian Linxue;Tan Xiaoqu;Liu Yujiang(Department of Ultrasound,Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院超声科,100050

出　　处：《中华医学超声杂志（电子版）》2021年第9期858-861,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：北京市医院管理局“登峰”人才培养计划(DFL20180102)。

摘　　要：目的探讨超声引导下平阳霉素硬化治疗胎盘植入的疗效价值。方法选取2014年1月至2017年10月首都医科大学附属北京友谊医院分娩后彩色多普勒超声及MRI均诊断胎盘植入的患者12例,氨甲蝶呤疗效不满意,经腹壁超声引导下胎盘植入处注入平阳霉素,观察术后血人绒毛膜促性腺激素(HCG)及胎盘植入体积变化,并观察术后并发症情况。结果12例患者术后(21±11)d血HCG均降至阴性,下降率(99.95±0.07)%,胎盘植入体积缩小率为(59.59±8.18)%,且与子宫肌壁分界尚清;3例患者术后1~2 d出现低热。清宫术后约1周,子宫内膜厚度为0.5~0.8 cm,清宫术后(32±13)d月经来潮。结论超声引导下平阳霉素注入可有效辅助治疗胎盘植入,为治疗方向提供帮助。Objective To evaluate the efficacy of ultrasound-guided pingyangmycin sclerotherapy for placenta accreta.Methods Twelve patients after childbirth were diagnosed with placenta accrete by color Doppler ultrasound and MRI at our hospital from January 2014 to October 2017.The efficacy of methotrexate was not satisfactory.Pingyangmycin was injected into the implanted placenta under the guidance of abdominal ultrasound.Then,the changes of human chorionic gonadotropin(HCG)in the blood,placental volume,and postoperative complications were observed.Results The HCG in the blood of the 12 patients were negative(21±11)days post sclerotherapy,with a decline rate of(99.95±0.07)%.The placental volume reduction rate was(59.59±8.18)%,and the implanted placenta had a relatively clear boundary with the uterine muscular wall.Three patients developed low fever 1-2 days post sclerotherapy.The thickness of the endometrium was about 0.5-0.8 cm about 1 week post curettage,and menstrual cramp occurred(32±13)days after curettage.Conclusion Ultrasound-guided Pingyangmycin sclerotherapy can effectively assist in the treatment of placental implantation.

关 键 词：胎盘植入 超声引导 平阳霉素 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.2[医药卫生—诊断学]