102例剖宫产术后子宫瘢痕处妊娠治疗效果评价  

Treatment of 102 cases w ith caesarean scar pregnancy

作　　者：赵真[1] 董白桦[1] 苏士利[1] 

机构地区：[1]山东大学齐鲁医院计划生育科,济南250012

出　　处：《山东大学学报（医学版）》2014年第1期75-78,共4页Journal of Shandong University:Health Sciences

摘　　要：目的评价剖宫产术后子宫瘢痕处妊娠的处理方式。方法回顾分析2006年1月至2012年2月山东大学齐鲁医院确诊的剖宫产术后子宫瘢痕处妊娠患者102例。分为甲氨蝶呤(MTX)肌内+宫腔注射组(A组)、MTX肌内+宫腔注射+超声引导下清宫组(B组)和子宫动脉灌注化疗栓塞+超声引导吸宫组(C组)。结果 A、B、C3组患者血绒毛膜促性腺激素(β-hCG)恢复至正常时间、瘢痕部位包块消失时间、阴道流血时间、住院时间、住院费用相比较差异有统计学意义(P<0.05)。A、B、C 3组患者治疗成功率分别为92.86%、88.52%、84.62%(P>0.05)。结论 3组方法均可达到较高的治愈率,但MTX肌内+宫腔注射方法简单,花费少,避免侵入性操作。Objective To evaluate the treatment of caesarean scar pregnancy. Methods Data of 102 patients with caesarean scar pregnancy treated during Jan. 2006 to Feb. 2012 were retrospectively reviewed with clinical cohort study. The patients were divided into 3 groups, including muscle and intrauterine cavity injection of methotrexate （ MTX, Group A）, MTX therapy followed by ultrasound-guided suction curettage （Group B） and uterine arteries embolization followed by low vacuum aspiration （Group C）. Results The mean resolution time of serum β-hCG, time taken for CSP mass to disappear, time of vaginal bleeding, hospital stay and costs were statistically different in the three groups （P〈0.05）. The success rate for Group A, B and C were 92.86%, 88.52% and 84.62%, respectively, with no statistically significant difference （P 〉 0.05 ）. Condusion All three therapies yield high success rate, while muscle and intrauterine cavity injection of methotrexate is effective, cheap and non-invasive.

关 键 词：剖宫产术 瘢痕妊娠 甲氨蝶呤 清宫术 子宫动脉栓塞术 

分 类 号：R715.2[医药卫生—妇产科学]