RESUMO
Objective To analyze the correlation between different types of placental implantation after cesarean section and previous cesarean section.Methods The data of 7 286 pregnant women with second pregnancy after cesarean section from January 2010 to October 2018 were retrospectively analyzed.Among them,842 cases had placental implantation.Five hundred and ninetyseven cases were adhesion type,204 cases were implantation type and 41 cases were penetration type.The relationship between the type of placental implantation in this pregnancy and emergency operation and postpartum hemorrhage during previous cesarean section and the time from this pregnancy was analyzed.Results The total incidence of placental implantation and the incidence of three types of placental implantation in the transfer operation group was higher than that of non-transfer operation group,total:27.4％ (419/1528) vs.7.3％ (423/5 758);adhesion type:18.0％ (275/1 528) vs.5.6％ (322/5 758);implantation type:7.9％ (121/1 528) vs.1.4％ (83/5 758);penetration type:1.5％ (23/1 528)vs.0.3％ (18/5 758),and there were significant differences (P＜0.01).The total incidence of placental implantation and the incidence of three types of placental implantation in postpartum hemorrhage group was higher than that in the non-postpartum hemorrhage group,total:33.9％ (74/218) vs.10.9％ (768/7 068);adhesion type:22.5％ (49/218) vs.7.8％ (548/7 068);implantation type:9.6％ (21/218) vs.2.6％ (183/7 068);penetration type:1.8％ (4/218) vs.0.5％ (37/7 068),and there were significant differences (P＜0.01).There was no statistical significance between the time of pregnancy and the incidence and total incidence of three types of placental implantation (P＞0.05).Conclusions Placental implantation after cesarean section may be closely related to emergency operation and postpartum hemorrhage during the previous cesarean section.Pregnant women with second pregnancy after cesarean section should strengthen the management of pregnancy.
RESUMO
Objective To evaluate the efficacy of a two-step infusion therapy with meropenem against noso-comial multi-drug resistant Pseudomonas aeruginosa infections in elderly patients with chronic obstructive pulmonary disease.Methods 112 elderly patients with nosocomial multi-drug resistant Pseudomonas aeruginosa infections and chronic obstructive pulmonary disease were randomized into two groups:two-step infusion therapy group ( rapid first-step infusion in 30 minutes and slow second-step infusion in 2.5 hours) and traditional 30 minutes infusion therapy group.The antibiotic clinical efficacy and bacteriological efficacy were observed between two groups .Results The clinical efficacy of observation group and control group were 82.2%(46/56) vs 57.1%(32/56).The difference was statistically significant(χ2 =10.185,P<0.05);The bacteriological efficacy of observation group and control group were 75.0%(42/56) vs 46.4%(26/56),The difference was statistically significant (χ2 =10.265,P<0.05). Conclusion The clinical efficacy and bacteriological efficacy of two-step infusion therapy with meropenem against nosocomial multi-drug resistant Pseudomonas aeruginosa infections in elderly patients with chronic obstructive pulmo -nary disease were superior to the traditional therapy .