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目的探讨胚胎体内注射生理盐水减胎的可行性。方法将2000年1月至2004年12月因2胎或2胎以上孕8~10周的多胎妊娠在广州市第二人民医院接受减胎的孕妇32例,分成两组,一组采用胚胎体内注射生理盐水减胎,为注射组;另一组采用机械破坏法减胎,为机械组。比较两组的手术时间、感染率、流产率、早产率、足月产率、平均孕周。结果两组病例均1次减胎手术成功。注射组减灭1个胎儿所需的时间为(5.8±1.8)min,非常显著地少于机械组的(18.6±10.2)min(P<0.01)。注射组术后无感染发生,机械组有1例发生感染。注射组的流产率、早产率分别为5.6%(1/18)和27.8%(5/18),低于机械组的21.4%(3/14)和28.6%(4/14),但无统计学意义。注射组的足月产率为66.7%(12/18),高于机械组的50.0%(7/14),无统计学差异。注射组平均孕周为(35.2±3.6)周,显著长于机械组的(32.1±4.1)周(P<0.05)。结论与机械破坏法比较,胚胎体内注射生理盐水是一种安全、有效、可行的减胎方法,适用于妊娠8~10周需要减胎的多胎妊娠孕妇。
Objective To investigate the feasibility of embryo injection of saline in vivo. Methods From January 2000 to December 2004, 32 pregnant women with multiple pregnancies of 2 to 7 weeks pregnant at 8 to 10 weeks of gestation were divided into two groups at the Second People’s Hospital of Guangzhou City, Injection of saline to reduce the injection group; the other group using mechanical destructive tire reduction, mechanical group. The operation time, infection rate, abortion rate, premature birth rate, full-term pregnancy rate and average gestational age were compared between the two groups. Results Two groups of patients were successful in one operation. The time required for injection of a fetus by one injection was (5.8 ± 1.8) min, significantly less than that of the mechanical group (18.6 ± 10.2) min (P <0.01). No infection occurred in the injection group and 1 case in the mechanical group. Abortion rates and preterm birth rates in the injected group were 5.6% (1/18) and 27.8% (5/18), respectively, which were lower than 21.4% (3/14) and 28.6% (4/14) in the mechanical group but no statistics Significance of learning. The full-term birth rate was 66.7% (12/18) in the injected group, which was higher than that in the mechanical group (50.0%, 7/14), with no significant difference. The average gestational age of the injected group was (35.2 ± 3.6) weeks, significantly longer than that of the mechanical group (32.1 ± 4.1) weeks (P <0.05). Conclusion Compared with the mechanical destruction method, injection of physiological saline into the embryo is a safe, effective and feasible method of reducing the fetus. It is suitable for pregnant women with multiple pregnancies needing to reduce the fetus from 8 to 10 weeks of gestation.