经阴道孕囊腔内注射氨甲喋呤辅以清宫术治疗剖宫产后切口妊娠的临床价值

目的]探讨B超监测下双腔拾卵针经阴道孕囊腔内注射氨甲喋呤(MTX)+清宫术治疗剖宫产术后切口妊娠(CSP) 的临床价值.方法]选取本院2005年1月至2010年6月收治的切口妊娠患者63例:14例予以MTX+清宫术(A组),22例予以MTX+宫腔镜术(B组),27例行B超监测下双腔拾卵针经阴道孕囊腔内注射MTX+清...

Clinical Value of Transvaginal Gestational Sac Injection of Methotrexate Assisted with Uterine Curettage for the Treatment of Cesarean Scar Pregnancy

Objective]To explore the clinical value of transvaginal gestational sac injection of methotrexate（MTX） by double lumen needle plus uterine curettage monitored by B-ultrasound for the treatment of cesarean scar pregnancy（CSP）. Methods] Sixty three CSP patients treated in our hospital from Jan. 2005 to June 2010 were chosen. Fourteen cases （group A） were given MTX plus uterine curettage. Twenty two cases（group B） were given MTX plus hysteroscopy. Twenty seven cases（group C） received transvaginal gestational sac injection of MTX by double lumen needle plus uterine curettage monitored by B-ultrasound. The successful rate of treatment and the incidence of the complications were compared among 3 groups. Results] There were significant differences in the effective rate, treatment duration, the time of uterine curettage and the incidence of adverse reactions of MTX between group A and group B（ P〈0.05）. There were also significant differences in blood loss, bleeding volume, intrauterine obturation, uterine perforation and the incidence of adverse reactions of MTX（92.6% ） between group C and group A and B（ P〈0.05）. There was no significant difference in intrauterine hematoma and uterus wedge resection among 3 groups（ P〉0; 05）. Conclusion] Transvaginal gestational sac injection of methotrexate（MTX） by double lumen needle plus uterine curettage monitored by B-ultrasound for the treatment of CSP has advantages such as high successful rate, less operation time, minimal maternal injury, short hospital day and low cost, etc. Therefore it is a safe and effective therapy method and worthy of being extended.