中孕完全性前置胎盘状态引产方式的探讨

Induced abortion modes of complete placenta previa during the second trimester of pregnancy

目的探讨中期妊娠完全性前置胎盘状态适宜的引产方式。方法回顾性分析2010年6月-2015年6月该院中孕完全性前置胎盘状态引产病例95例,其中利凡诺羊膜腔注射联合米菲司酮及间苯三酚经阴道引产患者60例(研究组),剖宫取胎患者35例(对照组),分析两种引产方式的安全性及经济和社会效益。结果研究组及对照组引产总出血量分别为(603.42±181.59)ml和(590.58±152.56)ml,两组比较差异无统计学意义(P>0.05);研究组及对照组产时出血量分别为(380.00±24.85)ml和(372.25±21.64)ml,两组比较差异无统计学意义(P>0.05);研究组及对照组产后24h内出血量分别为和(223.42±168.14)ml和(218.33±138.90)ml,两组比较差异无统计学意义(P>0.05);研究组平均住院天数为(6.27±0.91)d及平均住院费用为(3.67±2.09)千元,对照组对应为(9.83±0.65)d和(9.40±1.84)千元,两组比较差异有统计学意义(P<0.01),研究组的平均住院天数较对照组短,而平均住院费用较对照组低。研究组与对照组子宫切除率、产后大出血发生率分别为0.00%VS 2.86%、5.00%VS 5.71%,两组比较差异无统计学意义(P>0.05)。结论利凡诺羊膜腔注射联合米菲司酮及间苯三酚用于无胎盘植入的中孕完全性前置胎盘状态引产患者具有较好的经济效益,有可行性且安全,值得临床推广。

Objective To explore the suitable modes for induced abortion of complete placenta previa during the second trimester of pregnancy. Methods. Ninety-five patients undergoing induced abortion of complete placenta previa during the second trimester of pregnancy in the hospital from June 2010 to June 2015 were analyzed retrospectively, then they were divided into study group （60 patients treated by transvaginal induced abortion using amniotic cavity injection of rivanol combined with mifepristone and phloroglucinol） and control group （35 patients treated by hysterotomy delivery） . The safety, economic and social benefits of the two modes were analyzed. Results The total amounts of hemorrhage in study group and control group were （603.42±181.59） ml and （590. 58±152. 56） ml, respectively, there was no statistically significant difference between the two groups （P〉0.05） ; the amounts of intrapartum hemorrhage in study group and control group were （380. 00±24. 85） ml and （372. 25±21.64） ml, respectively, there was no statistically significant difference between the two groups （P〉0. 05） ; the amounts of hemorrhage within 24 hours after delivery in study group and control group were （223.42±168.14） ml and （218.33±138. 90） ml, respectively, there was no statistically significant difference between the two groups （P〉0.05） . The mean hospitalization time and expenses were （6. 27±0. 91 ） days and （3.67±2. 09） thousand Yuan in study group and （9. 83±0. 65） days and （9.40±1.84） thousand Yuan in control group, there were statistically significant differences between the two groups （P〈0. 01 ） , the mean hospitalization time in study group was shorter than that in control group, while the mean hospitalization expense in study group was lower than that in control group. There was no statistically significant difference in the rate of hysterectomy and the incidence rate of postpartum bleeding between the two groups （0. 00% vs. 2. 86% , 5.00% vs. 5.71%, P〉0. 05） . Conclusion The economic benefit of amniotic cavity injection of rivanol combined with mifepristone and phloroglucinol used for induced abortion of complete placenta previa during the second trimester of pregnancy is good with feasibility and safety, the method is. worthy of clinical promotion.