保守治疗胎盘植入的临床观察与护理

The observation and nursing of conservative treatment of implanted placenta

目的探讨甲氨蝶呤(MTX)肌肉注射联合米非司酮口服治疗胎盘植入性的疗效与护理。方法18例胎盘植入患者采用MTX联合米非司酮治疗。结果 18例胎盘植入患者经保守治疗,2周后复查B超,6例患者宫腔回声正常,4周后复查B超,11例患者宫腔回声正常,仅1例超声提示宫内不均质回声,大小约1.4 cm×1.9 cm,予诊刮。在治疗期间通过细心的观察和全面的护理均未发生严重的并发症。结论采用甲氨蝶呤联合米非司酮治疗胎盘植入,具有安全、简单、止血效果好、不易形成胎盘残留的优点,可以减少晚期产后出血,避免子宫切除,尤其对于年轻要求保留生育功能的妇女,在有效治疗的同时,可以最大限度地保留子宫。

Objective To explore the effect of MTX combined with oral treatment mifepristone on implantation of placenta. Methods 18 cases were treated with Methotrexate （MTX） and mifepristone. Results 18 cases of the placenta implanted MTX joint mifepristone influences the conservative treatment, two weeks after the B to exceed, 6 patients with uterine echo normal, all around to check after B to exceed, 11 patients with uterine echo normal, only 1 cases within the ultrasonic hint of uneven echo, about the size of 1.4 cm x 1.9 era, follow-up to scrape.Conclusion The treatment of implantation of placenta with MTX combined with oral treatment mffepristone is safe ,simple and little bleeding and residual placenta .It can reduce postpartum hemorrhage and avoiding hysterectomy.