腹腔镜结合甲氨蝶呤术前治疗Ⅱ型剖宫产瘢痕妊娠的疗效分析  

Analysis of Therapeutic Effect of Methotrexate before Laparoscopic Operation on Type Ⅱ Cesarean Scar Pregnancy Patients

作　　者：姚颖杰[1] 曹映华[1] 

机构地区：[1]昆明市妇幼保健院,云南昆明650000

出　　处：《中外医学研究》2014年第26期14-16,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的：探讨剖宫产瘢痕妊娠（Cesarean scar pregnancy,CSP）行腹腔镜保守性手术联合术前使用甲氨蝶呤MTX的可行性及安全性。方法：将笔者所在医院2008年10月-至今收治Ⅱ型剖宫产瘢痕妊娠患者37例分为两组。A组18例术前给予甲氨蝶呤50-75 mg静脉注射,B组19例术前不使用甲氨蝶呤,仅进行腹腔镜下瘢痕处妊娠物清除术。随后对手术前后激素指标、术中出血量、手术时长等参数进行分析。结果：两组患者均保留生育功能治愈出院。A组手术过程中出血量明显低于B组,A组手术时间明显高于B组,两组比较差异均有统计学意义（P〈0.05）。结论：腹腔镜保守性手术联合甲氨蝶呤治疗Ⅱ型剖宫产瘢痕妊娠具有创伤小、康复快的优点。在腹腔镜下可以对病情进行确诊,在瘢痕处妊娠物清除术的同时,也清除了与宫腔相连的腔隙与窦道,减少了再次发生CSP、胎盘植入的风险,值得推广。Objective： To evaluate the feasibility and safety of Methotrexate before laparoscopic operation on type H cesarean scar pregnancy patients. Method： 37 type Ⅱ cesarean scar pregnancy patients from our hospital were randomly divided into two groups.Group A was intravenous injected 50-75 mg Methotrexate before operation, while group B was solely treated with laparoscopic operation.Tbe parameters of operation result were analyzed with independent samples t-test.Result： Two groups of patients were reserved reproductive function and hospital cured.Compared with group B, bleeding volume during operation of group A were significantly reduced and operation duration of group A were signiflcandy rised（P〈0.05）.Conclusion： It is effective and micro-traumatic to use of Methotrexate before laparoseopic operation on type Ⅱ cesarean sear pregnancy patients.The diagnosis conclusion can be confirmed with laparoseope observation, meanwhile the sear pregnancy and sinus tract connected to uterine cavity ean be removed, which reduced the risk of recurrence of cesarean scar pregnancy and placenta aecreta.This treatment is worth of popularizing.

关 键 词：腹腔镜手术 甲氨蝶呤 剖宫产瘢痕妊娠 

分 类 号：R714.22[医药卫生—妇产科学]