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目的探讨甲氨喋呤(mTx)联合米非司酮保守治疗胎盘植入临床疗效。方法米非司酮片100mg口服连续5d,mTχ20mg肌内注射连续5d。注射mTx24小时后加用四氢叶酸25mg肌内注射连续5d,以降低mTx的毒副反应。结果 60例胎盘植入保守治疗均获成功,无一例因治疗无效出现产后出血而需介入治疗或切除子宫。结论 mTx联合米非司酮保守治疗胎盘植入安全、可靠,并减少了产时子宫切除机率。
Objective To investigate the clinical efficacy of methotrexate (mTx) combined with mifepristone in the conservative treatment of placenta accreta. Methods Mifepristone tablets 100mg orally for 5 days, mTχ20mg intramuscular injection of continuous 5d. Twenty-four hours after injection of mTx plus tetrahydrofolate 25mg intramuscular injection for 5d, in order to reduce the toxicity of mTx. Results 60 cases of placenta accreta received conservative treatment were successful, no case of ineffective treatment of postpartum hemorrhage due to interventional therapy or removal of the uterus. Conclusions The conservative treatment of mTx with mifepristone placenta accreta is safe, reliable and reduces the chance of hysterectomy during labor.