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卡前列素氨丁三醇联合米非司酮治疗凶险性前置胎盘的疗效及预后分析
作者:周密1  姚莉莉2  刘宗印1 
单位:1. 陕西省宝鸡市妇幼保健院 产科, 陕西 宝鸡 721000;
2. 解放军五三七医院 麻醉科, 陕西 宝鸡 721000
关键词:卡前列素氨丁三醇 凶险性前置胎盘 米非司酮 预后 临床疗效 
分类号:R714.56
出版年·卷·期(页码):2018·46·第六期(646-650)
摘要:

目的:探讨卡前列素氨丁三醇联合米非司酮治疗凶险性前置胎盘产妇的临床疗效及预后效果。方法:纳入我院2015年9月至2017年9月收治的凶险性前置胎盘产妇88例,根据随机数字表法分为两组,每组44例,两组均行剖宫产手术,术中均给予催产素及纱条填塞等常规治疗,对照组在此基础上给予米非司酮治疗,观察组给予卡前列素氨丁三醇联合米非司酮治疗,对比两组止血效果、术后24 h血流动力学指标、产妇预后效果以及不良反应发生情况。结果:观察组术中出血量、术后2 h阴道出血量和术后2~24 h阴道出血量与对照组比较,均显著减少(P<0.01),观察组产后出血发生率为9.09%,较对照组的25.00%显著降低(P<0.01)。两组术后24 h的收缩压、舒张压和平均动脉压均较术前显著下降(P<0.01),心率显著上升(P<0.01),但观察组变化幅度小于对照组(P<0.05)。观察组产褥病和弥散性血管内凝血发生率分别为2.27%、2.27%,均较对照组的15.91%、13.64%显著降低(P<0.01);观察组子宫切除率为0,与对照组的2.27%无明显差异(P>0.05);观察组血性恶露时间为(7.12±1.53) d,较对照组的(9.85±1.28) d显著缩短(P<0.01);观察组不良反应发生率为18.18%,与对照组的11.36%无明显差异(P>0.05)。结论:卡前列素氨丁三醇联合米非司酮治疗凶险性前置胎盘效果确切,产妇产后出血量少,血流动力学指标稳定,产妇预后效果好,不良反应轻微,有临床推广价值。

Objective:To investigate the clinical efficacy and prognosis of the treatment of dangerous placenta previa treated with cardoprost tromethamine and mifepristone. Methods:88 cases of pernicious placenta previa patients admitted to our hospital from September 2015 to September 2017 were randomly divided into two groups, 44 cases in each group.Patients in the two groups underwent cesarean section, and all patients were given conventional treatment of oxytocin and gauze strip, patients in control group were treated with mifepristone on this basis, patients in observation group were treated with pristinol three alcohol combined with mifepristone. Hemostatic effect, the hemodynamic index of 24 h after operation, the effect of maternal prognosis and the occurrence of adverse reactions in the two groups were compared. Results:2 h vaginal bleeding, intraoperative bleeding and postoperative 2-24 h vaginal bleeding volume ofthe observation group were significantly lower than those of the control group (P<0.01). Incidence of postpartum hemorrhage in the observation group was 9.09%, which was significantly lower than the 25.00% in the control group (P<0.01).Compared with the preoperative 24 h, the systolic blood pressure, diastolic blood pressure, and mean arterial pressure of the two groups decreased significantly after operation, and the heart rate increased significantly,however, the observation group changed less than the control group(P<0.05).The incidence of puerperal disease and disseminated intravascular coagulation in the observation group was 2.27% and 2.27%,compared with 15.91% and 13.64% in the control group, both were significantly decreased (P<0.01), in the observation group, there was no case of hysterectomy. The hysterectomy rate in the observation group was 0, which was equivalent to 2.27% in the control group(P>0.05), blood lochia duration in the observation group was (7.12±1.53) d, which was significantly shorter than that in the control group[(9.85±1.28) d, P<0.01]. The incidence of adverse reactions in the observation group was 18.18%, which was equivalent to 11.36% of the control group (P>0.05).Conclusion:Cataprost tromethamine combined with mifepristone is effective for the treatment of dangerous placenta previa, maternal postpartum hemorrhage is less, hemodynamic parameters are stable, maternal prognosis is good, adverse reactions are mild, and has clinical promotion value.

参考文献:

[1] 刘方波,纪向虹,王胜兰.1例凶险型前置胎盘的抢救护理体会[J].现代医学,2010,38(5):542-543.
[2] 徐金霞,刘福忠,吴兆晴,等.双侧髂内动脉球囊临时阻断术在凶险性前置胎盘剖宫产术中的应用[J].东南大学学报:医学版,2017,36(6):1019-1023.
[3] 于万芹.卡前列素氨丁三醇联合缩宫素在减少凶险性前置胎盘产后出血中的临床效果[J].河北医药,2017,39(12):1877-1879,1883.
[4] 曹泽毅.中华妇产科学[M].2版.北京:人民卫生出版社,2005:422.
[5] 曹丽琼,陈海燕,范莉君.卡前列素氨丁三醇联合纱条宫腔填塞治疗凶险性前置胎盘的疗效分析[J].国际妇产科学杂志,2014,41(4):441-442.
[6] 周月华.卡前列素氨丁三醇联合宫腔纱条填塞法治疗凶险型前置胎盘剖宫产术中出血的临床疗效[J].中国医学前沿杂志:电子版,2014,6(8):41-44.
[7] 胡建国,李瑞,梁义娟,等.卡前列素氨丁三醇与排式缝合术联合应用预防凶险型前置胎盘剖宫产产后出血的研究[J].河北医药,2015,37(9):1346-1348.
[8] 宋鸿碧,雷后康,李琴芬,等.卡前列素氨丁三醇在凶险性前置胎盘产后大出血产妇中的应用价值[J].中国医药导报,2015,12(27):112-115.
[9] 李雪.卡前列素氨丁三醇联合米非司酮治疗凶险性前置胎盘的疗效观察[J].中国生化药物杂志,2017,37(8):254-256.
[10] 范丽,高霞,马亚琳.卡前列素氨丁三醇联合低位B-Lynch缝合术治疗难治性前置胎盘性产后出血的临床分析[J].中华妇幼临床医学杂志:电子版,2013,9(2):201-204.
[11] 高湛.卡前列素氨丁三醇加宫腔填塞纱条在凶险型前置胎盘中的应用[J].中国妇幼保健,2012,27(36):6069-6070.
[12] 董黎,王瑜,王朕华,等.卡前列素氨丁三醇在中央性前置胎盘剖宫产术中的应用时机研究探讨[J].中国妇幼保健,2016,31(18):3701-3703.
[13] 魏红霞.卡前列素氨丁三醇联合缩宫素在中央性前置胎盘剖宫术的应用时机探讨[J].河南大学学报:医学版,2017,36(1):57-58.
[14] 和青森,杨建敏.卡前列素氨丁三醇应用时机对中央性前置胎盘剖宫产妇产后出血及血流动力学的影响[J].中国药房,2017,28(11):1535-1537.
[15] 杨琳芬,徐志红,杨帆.卡前列素氨丁三醇联合米非司酮在凶险性前置胎盘中的应用[J].重庆医学,2016,45(31):4422-4424.

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