子宫瘢痕妊娠3种治疗方案疗效观察

目的:观察3种治疗方案治疗子宫瘢痕妊娠的疗效。方法:将120例子宫瘢痕妊娠患者随机分为3组,每组40例。甲氨蝶呤(MTX)组静脉注射MTX,栓塞组采用明胶海绵子宫动脉栓塞术,联合组子宫动脉灌注MTX联合子宫动脉栓塞术。比较3组β-人绒毛膜促性腺激素(β-hCG)恢复情况、出血总量、治疗7 d妊娠囊直径、住院时间、临床疗效和不良反应。结果:联合组治疗3 d、7 d后血清β-hCG水平均明显低于栓塞组和MTX组(P<0.01),出血总量显著少于栓塞组和MTX组(P<0.01),治疗7 d后妊娠囊直径均明显小于栓塞组和MTX组(P<0.01),β-hCG恢复正常时间及住院时间均显著短于栓塞组和MTX组(P<0.01)。3组患者临床疗效和不良反应差异均无统计学意义(P>0.05)。结论:子宫动脉灌注MTX联合子宫动脉栓塞术治疗子宫瘢痕妊娠临床效果好,不良反应未增加。

The curative effect of three methods in the treatment of uterine scar pregnancy

Objective:To observe the curative effects of three methods in the treatment of uterine scar pregnancy(CSP). Methods:One hundred and twenty patients with CSP were randomly divided into the methotrexate ( MTX ) group, embolization group and combination group ( 40 cases each group ) . The MTX group, embolization group and combination group were treated with MTX intravenous injection,gelatin sponge perfusion in uterine artery and combination with the above two methods,respectively. The levels ofβ-human chorionic gonadotrophin(β-hCG) ,intraoperative and postoperative hemorrhage volume,diameter of gestational sac after 7 days of treatment,hospitalization time and clinical efficacy and adverse reactions among three groups were compared. Results:The serum levels of β-hCG in combination group after 3 days and 7 days of treatment were obviously lower than those in embolization group and MTX group(P<0. 01). The total hemorrhage volume in the combination group was obviously less than that in embolization group and MTX group(P<0. 01). The diameter of gestational sac after 7 days of treatment was significantly smaller than that in embolization group and MTX group(P<0. 01). The time of β-hCG level recovery and hospitalization in combination group were obviously shorter than those in embolization group and MTX group(P<0. 01). The differences of clinical curative effects and adverse reactions among three groups were not statistically significant(P>0. 05). Conclusions:The treatment of uterine scar pregnancy with MTX perfusion combined with embolization in uterine artery has good clinical effects,and the adverse reactions do not be increased.