子宫动脉栓塞联合甲氨蝶呤治疗子宫切口瘢痕妊娠的临床分析

目的观察子宫动脉栓塞(uterine arterial embolization,UAE)联合甲氨蝶呤(Methotrexate,MTX)治疗子宫切口瘢痕妊娠(cesarean scar pregnancy,CSP)的临床疗效。方法将64例CSP患者随机分为观察组和对照组,每组各32例,观察组行UAE联合MTX治疗,栓塞治疗后24~48 h内在B超监测下行胚胎钳刮术;对照组在阴道超声引导下局部注射MTX,择期行清宫术,比较两组的临床疗效。结果观察组治愈率、第4天血清β-人绒毛膜促性腺激素(human chorionic gonadotrophin,HCG)的降幅高于对照组(P0.05);观察组术中出血量、阴道流血时间、包块消失时间、住院时间、血清β-HCG转阴时间均少于对照组(P0.05);两组不良反应发生率比较无明显差异(P0.05)。结论 UAE联合MTX治疗CSP疗效显著,安全可靠,值得临床推广。

Clinical analysis of uterine artery embolism combined with Methotrexate in treatment of cesarean scar pregnancy

Objective To observe the clinical effect of uterine artery embolism （ UAE ） combined with Methotrexate in treatment of cesarean scar pregnancy （ CSP ） . Methods 64 cases of the patients were randomly divided into observation group and control group,with 32 cases in each group. The cases in observation group were treated with UAE and Methotrexate,and underwent curettage in 24 to 48 hours. The cases in control group were given Methotrexate by local injection and curettage. The clinical effects of two groups were compared. Results The cure rate,day 4 serumβ-HCG level decline in observation group were significantly higher than control group（P〈0. 05）. The hemorrhage volume,vaginal bleeding time,mass disappearance time,length of hospital stay and time for serumβ-HCG recover to normal in observation group were less than control group （ P〈0. 05 ） . There was no significant difference in the incidences of adverse reactions between two groups （ P〉0. 05 ） . Conclusion Using uterine artery embolism combined with Methotrexate in treatment of CSP is effective,safe and reliable,which is worthy of clinical application.