宫颈多重缝扎术与米非司酮联合治疗凶险性前置胎盘的有效性分析

Analysis on Effectiveness of Multiple Cervical Ligation Combined with Mifepristone in the Treatment of Dangerous Placenta Previa

目的 :探讨宫颈多重缝扎术联合米非司酮治疗凶险性前置胎盘的有效性。方法 :选取2015年4月—2017年5月我院收治的56例凶险性前置胎盘患者作为研究对象,按随机数字表法分为研究组与对照组,各28例。对照组应用宫颈多重缝扎术治疗,研究组在对照组基础上联合米非司酮(25 mg,bid)治疗,比较两组手术时间、术中总出血量、术后2 h出血量、术后异常体温时间、血性恶露持续时间、胎盘植入率、子宫切除率及新生儿窒息率。结果:两组手术持续时间、术中总出血量比较,差异无统计学意义(P> 0.05);研究组术后2 h出血量、子宫切除率低于对照组,术后异常体温时间、血性恶露持续时间短于对照组,差异均有统计学意义(P <0.05);两组胎盘植入率、新生儿窒息率比较,差异无统计学意义(P> 0.05)。结论 :宫颈多重缝扎术联合米非司酮治疗凶险性前置胎盘能降低围术期出血量及子宫切除率,缩短体温异常及恶露持续时间,值得推广使用。

Objective: To investigate the effectiveness of multiple cervical ligation combined with mifepristone in the treatment of dangerous placenta previa. Methods: 56 patients with dangerous placenta previa admitted to our hospital from April 2015 to May 2017 were selected and randomly divided into a study group and a control group, 28 cases in each group. The patients in the control group were treated by multiple cervical ligation, and the patients in the study group were treated with mifepristone(25 mg, bid) on the basis of the control group. The operation time, total intraoperative bleeding volume, postoperative 2 h bleeding volume, postoperative abnormal body temperature time, duration of bloody lochia, placental implantation rate, hysterectomy rate and neonatal asphyxia rate were compared between the two groups. Results: There was no statistically significant difference in operation duration and total intraoperative bleeding volume between the two groups(P>0.05). The postoperative 2 h bleeding volume and hysterectomy rate in the study group were lower than those in the control group, and the postoperative abnormal body temperature time and duration of bloody lochia were shorter than those in the control group, with statistically significant differences(P<0.05). There was no statistically significant difference in placental implantation rate and neonatal asphyxia rate between the two groups(P>0.05). Conclusion: Multiple cervical ligation combined with mifepristone for the treatment of dangerous placenta previa can reduce perioperative bleeding volume and hysterectomy rate and shorten abnormal body temperature time and the duration of lochia, which is worth promoting.