切口妊娠临床治疗60例分析

目的 比较阴道B超引导下抽吸减胎术联合局部甲氨蝶呤(MTX)注射与子宫动脉栓塞联合腹部B超引导下清宫术治疗切口妊娠的疗效.方法 回顾性分析2007年4月至2012年2月收治的子宫下段剖宫产后切口妊娠共60例患者的临床资料.结果 阴道B超引导下抽吸减胎术联合局部MTX注射在手术次数,手术时间,术中出血量,术中、术后疼痛,术后并发症,住院费用等方面明显优于子宫动脉栓塞联合腹部B超引导下清宫术(P＜0.01),两组在住院时间上差异无统计学意义.结论 随着对切口妊娠的认识及超声技术的飞速发展,切口妊娠可以得到早期诊断.阴道B超引导下抽吸减胎术联合局部MTX注射在治疗上明显优于子宫动脉栓塞联合腹部B超引导下清宫术.

Analysis on clinical treatment of 60 cases of cesarean scar pregnancy

Objective To compare the effects between transvaginal B ultrsound guided aspiration fetal reduction + local MTX injection and uterine arterial embolization + abdominal B ultrasound guided uterine curettage for treating cesarean scar pregnancy(CSP).Methods The clinical data in 60 cases of CSP in our hospital from Aprial 2007 to February 2010 were retrospectively analyzed.Results The operation times,operation time,introperative blood loss,intraoperative and postoperative pain,postoperative complications and hospitalization costs in transvaginal B ultrsound guided aspiration fetal reduction+local MTX injection were significnatly superior to those in uterine arterial embolization + abdominal B ultrasound guided uterine curettage,showing statistical differences between the two treatment regimens(P<0.01).Whereas there was no statistical difference in the length of hospital stay(P>0.05).Conclusion With the understanding of CSP and the rapid development of ultrasonic technology,CSP can be early diagnosed.Tranvaginal B ultrsound guided aspiration fetal reduction plus local MTX injection technique is obviously superior to uterine artery embolization plus uterine curettage guided by abdominal B ultrasound.