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目的:观察中期引产后应用甲氨蝶呤、米非司酮结合中药疗法对胎盘植入的临床疗效。方法:回顾分析80例中期引产后胎盘植入患者临床资料,依据治疗方式分为观察组44例及对照组36例,对照组以甲氨蝶呤单次肌肉注射及米非司酮口服治疗;观察组在对照组治疗的基础上加用中药治疗。观察2组患者治疗前及治疗后3周血清β-人绒毛膜促性腺激素(β-HCG)改变情况,对比2组B超所示胎盘面积。结果:痊愈率观察组为93.18%,对照组为33.33%,2组比较,差异有非常显著性意义(P<0.01)。治疗后1、2、3周后,2组β-HCG值均较治疗前显著下降(P<0.01);观察组β-HCG值下降较对照组同期更显著(P<0.05,P<0.01)。治疗后1、2周后,2组宫腔内病灶面积均较前显著缩小(P<0.01);观察组面积缩小较对照组同期更显著(P<0.01)。结论:中期引产后应用甲氨蝶呤、米非司酮结合中药疗法对胎盘植入予以保守治疗,能够加强各药协同作用,效果显著。
Objective: To observe the clinical effect of methotrexate and mifepristone combined with traditional Chinese medicine on placenta accreta after mid-term induction of labor. Methods: The clinical data of 80 patients with midplacental placenta accreta were retrospectively analyzed. According to the treatment mode, 44 patients in the observation group and 36 patients in the control group were treated. The control group was given single intramuscular injection of methotrexate and mifepristone orally. Observation group in the control group based on the use of traditional Chinese medicine treatment. The changes of serum β-human chorionic gonadotropin (β-HCG) before treatment and 3 weeks after treatment were observed in two groups of patients, and the placental area of the two groups was compared. Results: The cure rate was 93.18% in the observation group and 33.33% in the control group. There was significant difference between the two groups (P <0.01). After 1, 2 and 3 weeks of treatment, the β-HCG values of two groups were significantly lower than those before treatment (P <0.01). The decrease of β-HCG in the observation group was more significant than that of the control group at the same period (P <0.05, P <0.01) . After 1 and 2 weeks of treatment, the intrauterine lesion size of the two groups were significantly reduced (P <0.01); the area of the observation group shrink more significantly than the control group (P <0.01). Conclusion: Methotrexate is used after mid-term induction of labor. Mifepristone combined with traditional Chinese medicine is a conservative treatment of placenta accreta. It can enhance the synergistic effect of each drug and has a significant effect.