不同情况下孕中期前置胎盘状态终止妊娠最适宜方式及性生活质量影响

Study on the most appropriate mode of termination of pregnancy in placenta previa under different conditions

目的探讨不同情况下孕中期前置胎盘状态终止妊娠最适宜方式及患者预后情况。方法选取2014年2月至2016年10月间安康市妇幼保健院诊治的胎盘前置状态并终止妊娠患者118例进行回顾性分析。其中接受利凡诺羊膜腔注射联合米菲司酮及间苯三酚经阴道引产术60例作为研究组,年龄(28.4±3.6)岁,孕周(22.6±1.7)周,孕次(3.7±2.1)次;接受剖宫取胎手术58例作为对照组,年龄(29.1±4.2)岁,孕周(21.7±2.3)周,孕次(3.3±1.9)次;分析两组患者总出血数量、产时的出血数量、产后的出血数量、平均住院费用、产后出血发生率、平均住院天数、产妇死亡率、子宫切除率及患者术后一年性生活情况。结果研究组和对照组患者在总出血量、引产时的出血量和引产后24小时的出血量对比,差异均无统计学意义(均P>0.05);研究组患者平均住院费用和住院天数均低于对照组,差异具有统计学意义(P<0.05);研究组患者和对照组患者在产妇死亡率、子宫切除、产后大出血和子宫动脉栓塞术方面对比差异均无统计学意义(均P>0.05);研究组患者性欲望、性满意度、性唤起、性高潮和阴道润滑得分均高于对照组,差异具有统计学意义(P<0.05)。结论孕中期前置胎盘状态终止妊娠需要根据患者具体情况来确定患者的处理方法,在条件允许下可优先考虑阴道分娩,阴道分娩有一定的安全性,对患者损伤小,产后恢复速度较快。

Objective To study the best way to terminate the placenta in the second trimester of pregnancy under different conditions.Methods A retrospective analysis of 118 cases of placenta previa and termination of pregnancy in Ankang maternal and child health care hospital from February 2014 to October 2016 was carried out,the amniotic cavity injection of rivanol combined with mifepristone and benzene three phenol receive vaginal abortion patients have 60 cases,as the study group,mean age 28.4±3.6 years old,the average gestational age of 22.6±1.7 week average pregnancy 3.7+2.1;accept caesarean operation in 58 cases,as control group,mean age 29.1±4.2 years old,the average gestational age of 21.7±2.3 weeks,the average gestational time 3.3±1.9 times;the total number of 2 groups of patients with bleeding,intrapartum hemorrhage quantity,postpartum hemorrhage quantity,the average cost of hospitalization,the incidence of postpartum hemorrhage,the average hospitalization days,the maternal mortality rate,the rate of hysterectomy and postoperative one year of life.Results The study group and the control group of patients in the total amount of bleeding,the bleeding induced contrast 24 hours of bleeding and abortion,there were no significant differences(P>0.05);patients in the study group,the average hospitalization expenses and hospitalization time were lower than the control group,the difference was statistically significant(P<0.05);patients in the study group and the control group were not statistically significant in maternal mortality,hysterectomy,postpartum hemorrhage and uterine artery embolization contrast difference(P>0.05),The sexual desire,sexual satisfaction,sexual arousal,orgasm and vaginal lubrication scores of the study group were higher than those of the control group,the difference was statistically significant(P<0.05).Conclusions The second trimester termination of pregnancy placenta previa patients need treatment method to determine according to the specific circumstances of patients,in the preferred vaginal delivery is allowed under the conditions of vaginal delivery have certain safety,little injury to patients,postpartum recovery speed.