盐酸利托君治疗前置胎盘的疗效观察(1)
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[摘要] 目的:探讨盐酸利托君在前置胎盘治疗中的临床疗效。方法:对50例使用盐酸利托君和50例使用硫酸镁的前置胎盘患者进行回顾性临床分析,对用药后的阴道出血情况、治疗效果、妊娠结局和不良反应进行比较。结果:利托君组的保胎成功率、显效时间、延长孕周、妊娠期≥36周比率均明显优于硫酸镁组,且两组间差异均有统计学意义(P<0.05);两组阴道出血、产后出血情况和围生儿结局无明显差别(P>0.05);盐酸利托君和硫酸镁有不同的药品不良反应。结论:盐酸利托君抑制宫缩效果优于硫酸镁,是治疗前置胎盘的一种有效药物。
[关键词] 盐酸利托君;硫酸镁;前置胎盘
[中图分类号] R714.21[文献标识码]C [文章编号]1673-7210(2010)06(a)-091-02
Efficacy on Ritodrine Hydrochloride for placenta previa
SUN BingchunYANG Haili
(Teaching and Research Section of Gynecology and Obstetrics, the Second Clinical Institute of Guangdong Medical College, Dongguan 528000, China)
[Abstract] Objective: To evaluate the clinical efficacy of Ritodrine Hydrochloride for placenta previa. Methods: 50 patients with placenta previa treated with Ritodrine Hydrochloride and 50 patients with placenta previa treated with Magnesium Sulfate were analyzed retrospectively. The colporrhagia, therapeutic efficacy, pregnancy outcome and the adverse effect were compared after medication. Results: Compared with Magnesium Sulfate group, there was a significantly higher proportion of achievement ratio of tocolysis, reactive time, extension of pregnancy period and rate of gestation period over 36 weeks in Ritodrine Hydrochloride group(P<0.05). There was no differences between the two groups in colporrhagia, postpartum hemorrha and perinatal outcome(P>0.05). The two drugs had different adverse drug reactions. Conclusion: Ritodrine Hydrochloride is better than Magnesium Sulfate on inhibiting uterine contraction. It is an effective drug in treating placenta previa.
[Key words] Ritodrine Hydrochloride; Magnesium Sulfate; Placenta previa
前置胎盘是妊娠晚期出血的常见原因,处理不当将严重威胁母儿的生命安全。在前置胎盘治疗中,抑制宫缩、减少产前出血、延长孕龄是治疗成功的关键[1]。硫酸镁是目前最常用的宫缩抑制剂,但由于其作用较温和,显效慢,有效浓度非常接近中毒浓度,在临床治疗中存在一定的局限性。近年来,笔者采用盐酸利托君治疗前置胎盘,为探讨其疗效,对相关资料进行了回顾性临床分析,现报道如下:
1 资料与方法
1.1 一般资料
在2007年7月～2009年12月广东医学院附院收治前置胎盘患者中,随机抽取用盐酸利托君进行期待治疗的患者50例为利托君组;用硫酸镁治疗的同类患者50例为硫酸镁组。入选患者均因阴道出血就诊,均符合诊断标准[2]。患者入院时一般情况好,胎儿存活,无大量活动性出血(阴道流血量<500 ml),无使用盐酸利托君和硫酸镁的禁忌证。两组患者具有可比性。
1.2 方法
治疗组:盐酸利托君(台湾信东化学工业股份有限公司生产,商品名安宝)100 mg溶于5%葡萄糖液500 ml中,静脉滴注,初始剂量1 min 5滴,根据宫缩情况每10分钟增加5滴,直到宫缩抑制或最大量0.35 mg/min,有效剂量维持18 h后停止静脉滴注,停药前30 min改口服安宝(10 mg/片),第1天10 mg/2 h,第2天20 mg/4 h,从第3天起以20 mg/6 h维持,维持8 d停药,用药时注意孕妇和胎儿心率 ......
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