宫颈妊娠29例临床分析  

Clinical analysis of 29 cases of cervical pregnancy

作　　者：梁海霞[1] 陈必良[1] 李玉虹[2] 张魁[2] 

机构地区：[1]第四军医大学附属西京医院妇产科,陕西西安710032 [2]解放军451医院妇产科,陕西西安710054

出　　处：《中国现代医学杂志》2012年第22期68-71,共4页China Journal of Modern Medicine

摘　　要：目的总结宫颈妊娠的诊断和治疗经验。方法回顾性分析29例宫颈妊娠患者的临床资料,比较3种治疗方法的效果。结果 29例患者中25例通过B超确诊,其中10例采用单纯甲氨蝶呤(MTX)局部注射,15例采用MTX局部注射+清宫术,4例行直接清宫术。单纯MTX局部注射组的阴道出血时间为(20.81±7.24)(10～35)d,明显长于MTX+清宫组的(7.54±2.17)(4～13)d(P=0.0002)和直接清宫组的(6.7±2.2)(4～9)d(P=0.0001);单纯MTX局部注射组的住院时间为(12.30±3.33)d,明显长于MTX+清宫组的(9.07±2.74)d(P=0.017)和直接清宫组的(5.25±3.86)d(P=0.001)。3组住院费用差异无显著性(P=0.853)。单纯MTX局部注射组血HCG转阴时间为(18.60±3.20)d,明显长于MTX+清宫组的(13.93±2.18)d(P=0.0001)和直接清宫组的(11.50±2.08)d(P=0.0008)。结论 B超对于宫颈妊娠的诊断具有重要价值,MTX局部注射+清宫术治疗宫颈妊娠安全、可靠。【Objective】To investigate the diagnosis and treatment of cervical pregnancy.【Methods】The clinical data of 29 patients with cervical pregnancy were retrospectively reviewed.The clinical effectiveness of three treatment modes was compared.【Results】Of these 29 patients,25 patients were diagnosed by B-ultrasound.All patients selected fertility-preserved treatment,which included methotrexate（MTX） injection（n =10）,curettage after MTX injection（n =15） and curettage directly（n =4）.The time of vaginal hemorrhage was（20.81±7.24） days in MTX injection group,which was significant longer than in curettage after MTX injection group（7.54±2.17） days（P =0.0002） and curettage directly group（6.70±2.20）d（P =0.0001）.The duration of hospitalization was（12.30±3.33） days in MTX injection group,which was significant longer than in curettage after MTX injection group（9.07 ±2.74） days（P = 0.017） and curettage directly group（5.25±3.86） days（P =0.001）.The mean hospitalization cost showed no significant difference among three groups（P =0.853）.The duration that human chorionic gonadotropin（HCG） became negative in MTX injection group was（18.60±3.20） days,which was significant longer than in curettage after MTX injection group（13.93±2.18） days（P =0.0001） and curettage directly group（11.50±2.08） days（P =0.0008）.【Conclusion】Bultrasound is useful for the diagnosis of cervical pregnancy.Curettage after MTX injection is safe and effective for patients of cervical pregnancy.

关 键 词：宫颈妊娠 甲氨蝶呤 清宫术 

分 类 号：R714.2[医药卫生—妇产科学]