子宫动脉栓塞术和全身甲氨蝶呤治疗剖宫产术后瘢痕妊娠的疗效比较

目的评价子宫动脉栓塞术在剖宫产术后瘢痕妊娠中的临床疗效。方法回顾性分析67例剖宫产术后瘢痕妊娠患者的临床资料。将患者分为栓塞组(n=35)和甲氨蝶呤组(n=32),2组患者均行宫腔镜手术治疗,栓塞组行双侧子宫动脉栓塞术,甲氨蝶呤组肌肉注射甲氨蝶呤。观察2组患者术中出血量、住院时间、术后血人绒毛膜促性腺激素(HCG)转阴时间、月经恢复时间、病灶消失时间等指标,并进行比较。结果 2组患者治疗后血HCG转阴时间、住院时间、病灶消失时间及术中出血量比较,差异均有统计学意义(P<0.05);月经恢复时间2组间比较差异无统计学意义(P>0.05)。2组不良反应发生情况比较差异无统计学意义(P>0.05)。结论子宫动脉栓塞联合宫腔镜下清宫术治疗剖宫产术后瘢痕妊娠安全、有效。

Comparison of the efficacy of uterine artery embolization and systematic methotrexate on cesarean scar pregnancy

Objective To evaluate the efficacy of uterine artery embolization in treating of cesarean scar pregnancy.Methods The clinical data of sixty-seven women with pregnancy within cesarean scar were analyzed retrospectively. All patients were divided into embolization group（n = 35）and methotrexate group（n = 32）. All patients underwent hysteroscopic surgery;the patients in embolization group and methotrexate group were given uterine artery embolization and methotrexate（ intramscular injection） respectively. The intraopertative blood loss,hospitalization time,the time of serum human chorionic gonadotroph（HCG） resolution,the recover time of menses,and the time of lesion disappearance were analyzed and compared between the two groups. Results There were statistic difference of the time of serum HCG resolution,hospitalization time,the time of lesion disappearance,and intraopertative blood loss between the two groups after treatment（ P〈0. 05）. There was no statistic difference of he recover time of menses between the two groups（P〉0. 05）. There was no statistic difference of incidence of adverse reaction between the two groups（ P〉0. 05）. Conclusion The uterine artery embolization combined with hysteroscopic surgery for treatment of cesarean scar pregnancy is safe and effective.