| 摘要: |
| 目的:观察加味生化汤联合米非司酮治疗产后胎盘残留的疗效及对子宫恢复、应激反应的影响。方法：将产后胎盘残留患者186 例随机分成治疗组和对照组，每组各93 例。对照组予以米非司酮治疗，治疗组在对照组的基础上联合加味生化汤治疗。2组均以7 d为1个周期，治疗4个周期后观察2组临床疗效，治疗前后胎盘残留面积、子宫内膜厚度、人绒毛膜促性腺激素（β-hCG）水平、阴道流血时间、子宫体积、盆腔感染情况以及机体应激反应指标［血清超氧化物歧化酶（SOD）、过氧化氢酶（CTA）、活性氧簇（ROS）］。结果：总有效率治疗组为96.77%（90/93），高于对照组的89.25%（83/93），组间比较，差异均有统计学意义（P＜0.05）；治疗后治疗组胎盘残留面积、子宫内膜厚度、β-hCG水平、子宫体积各项指标值均低于对照组，阴道流血持续时间短于对照组，组间比较，差异有统计学意义（P＜0.01）；盆腔感染率与对照组相比，差异无统计学意义（P＞0.05）；其SOD、CTA高于对照组，ROS低于对照组，差异均有统计学意义（均P<0.01）。结论：加味生化汤联合米非司酮治疗产后胎盘残留的临床效果较好，可有效缩小残留胎盘面积、促进子宫恢复及减轻机体应激反应。 |
| 关键词: 产后胎盘残留 米非司酮 加味生化汤 子宫恢复 应激反应 |
| DOI： |
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| Clinical effect of Jiawei Shenghua decoction combined with mifepristone in treatment of postpartum placental residue：An analysis of 93 cases |
| XUE Shuwen |
| (Luoyang Maternal and Child Health Hospital，Luoyang 471000，Henan，China) |
| Abstract: |
| Objective：To investigate the clinical effect of Jiawei Shenghua decoction combined with mifepristone in the treatment of postpartum placental residue and its effect on uterine recovery and stress response.Methods：A total of 186 patients who experienced postpartum placental residue were enrolled and randomly divided into treatment group and control group，with 93 patients in each group.The patients in the control group were given mifepristone，and those in the treatment group were given Jiawei Shenghua decoction in addition to the treatment in the control group.Each course of treatment was 7 days，and both groups were treated for 4 courses.After treatment，the two groups were compared in terms of clinical outcome，area of placental residue，endometrial thickness，β-human chorionic gonadotrophin (β-hCG) level，vaginal bleeding time，uterine volume，pelvic infection，and stress response indices ［serum superoxide dismutase (SOD)，catalase (CTA)，and reactive oxygen species (ROS)］ before and after treatment.Results：There was a significant difference in overall response rate between the treatment group and the control group ［96.77% (90/93) vs 89.25% (83/93)，P<0.05］.Compared with the control group after treatment，the treatment group had a significantly smaller area of placental residue，significantly lower endometrial thickness，β-hCG level，and uterine volume，and a significantly shorter vaginal bleeding time (P<0.01).There was no significant difference in pelvic infection rate between the two groups (P>0.05)，and compared with the control group，the treatment group had significantly higher levels of SOD and CTA and a significantly lower level of ROS (all P<0.01).Conclusion：Jiawei Shenghua decoction combined with mifepristone has a good clinical effect in the treatment of postpartum placental residue and can effectively reduce the area of placental residue，promote uterine recovery，and alleviate stress response. |
| Key words: postpartum placental residue mifepristone Jiawei Shenghua decoction uterine recovery stress response |
