家庭病床和住院管理前置胎盘期待治疗的前瞻性对照研究

目的:探讨家庭病床管理前置胎盘期待治疗的安全性、效果和费用。方法:62例妊娠28~36周因"阴道流血"入院期待治疗的部分或边缘性前置胎盘孕妇,病情稳定后按照孕妇及家属意愿进入家庭病床组和住院治疗组继续进行期待治疗,比较两组孕妇期待治疗的天数、期待治疗平均住院天数、进入研究后阴道流血次数、新生儿出生体重、孕妇输血率和新生儿转新生儿监护病房(NICU)率。结果:两组进入研究后阴道流血次数、新生儿出生体重、孕妇输血率、新生儿转NICU率差异均无统计学意义(P0.05)。家庭病床组和住院治疗组期待治疗的时间分别是(20.47±11.96)天、(20.44±11.02)天,两组比较差异无统计学意义(P0.05),两组期待治疗平均住院天数分别是(3.93±4.69)天、(20.44±11.02)天,两组比较差异有统计学意义(P0.05)。结论:经过选择的前置胎盘孕妇,家庭病床管理期待治疗安全、有效、经济,有望替代传统的住院期待治疗。

Expectant treatment of placenta previa:a prospective,controlled trial of family ward and inpatient management

Objective:To explore the safety,efficacy and costs of expectant treatment of placenta previa by family ward management.Methods:62 pregnant women of 28～36 gestational weeks with partial and marginal placenta previa who received expectant treatment because of vaginal bleeding were selected and divided into family ward group and inpatient treatment group according to the wills of pregnant women and their families,the time of expectant treatment,average hospitalization days of expectant treatment,the number of vaginal bleeding,neonatal birth weight,the rate of blood transfusion and the rate of transferring to neonatal intensive care unit(NICU) in the two groups were compared.Results:There was no significant difference in the number of vaginal bleeding,neonatal birth weight,the rate of blood transfusion and the rate of transferring to NICU between the two groups(P>0.05),the times of expectant treatment in family ward group and inpatient treatment group were(20.47±11.96) days and(20.44±11.02) days,respectively,there was significant difference(P<0.05).Conclusion:For the selected pregnant women suffering from placenta previa,family ward management is safe,effective and economic,which may replace traditional inpatient management probably.