260例子宫切口瘢痕妊娠不同治疗方法的临床效果对比分析  

Clinical analysis of different treatments for cesarean scar pregnancy: report of 260 cases

作　　者：廖娅萍[1] 谭毅[1] 高莉[1] 

机构地区：[1]云南省第二人民医院妇科,昆明650021

出　　处：《第三军医大学学报》2016年第8期901-904,共4页Journal of Third Military Medical University

摘　　要：目的比较子宫切口瘢痕妊娠不同治疗方法的临床疗效。方法回顾性分析云南省第二人民医院妇科2010年1月至2014年12月期间收治的子宫切口瘢痕妊娠患者260例的临床资料,将260例患者按照不同的治疗方式分为3组:1甲氨蝶呤及孕囊穿刺组(A组,n=112),2甲氨蝶呤及子宫动脉栓塞术组(B组,n=82),3经阴道子宫切口瘢痕妊娠病灶切除术组(C组,n=66),比较3组患者治疗后成功率、1周后β-HCG下降比例、β-HCG转阴时间、包块消失时间及住院时间。结果 B和C组患者的治疗成功率明显高于A组,差异有统计学意义(P<0.05)。B组和C组患者β-HCG下降比例均高于A组患者(P<0.05),且B组和C组β-HCG转阴时间及住院时间均短于A组(P<0.05),另外,C组患者β-HCG转阴时间及β-HCG下降比例优于B组,差异有统计学意义(P<0.05),B组患者住院时间短于C组(P<0.05)。结论子宫动脉栓塞联合甲氨蝶呤治疗成功率高,能缩短住院时间和β-HCG转阴时间,并促进β-HCG下降比例,是安全、有效的子宫切口瘢痕妊娠治疗方法。Objective To explore the curative effect of different treatments for cesarean scar pregnancy（ CSP）. Methods Clinical data of 260 CSP patients hospitalized in the gynecology department from January 2010 to December 2014 were collected and retrospectively analyzed. The patients were divided into group A（ treated with methotrexate and gestational sac puncture,n = 112）,group B（ treated with methotrexate and uterine arterial embolization,n = 82）,and group C（ lesion resection of CSP via vagina,n =66）. The success rate of treatment, serum β-HCG decline proportion after 1 week, period of HCG normalization,CSP mass disappearance time and hospital stay were observed after different treatments.Results Group B and group C were higher in the success rate of treatment than group A,and the difference was statistically significant（ P〈0. 05）. In addition,it was found the serum β-HCG decline proportion was higher in group B and group C compared with group A（ P〈0. 05）,and the period of HCG normalization and the hospital stay were shorter（ P〈0. 05）. In the other hand,the serum β-HCG decline proportion and the period of HCG normalization in group C were superior to those in group B, and the differences were statistically significant（ P〈0. 05）. The hospital stay in group B was shorter than that in group C（ P〈0. 05）. Conclusion Methotrexate combined with uterine arterial embolization exhibits higher success rate of treatment,reduces the hospital stay and the period of HCG normalization,and promotes the decline of serumβ-HCG. So it is a safe and efficient method for treating CSP.

关 键 词：子宫切口瘢痕妊娠 甲氨蝶呤 穿刺 子宫动脉栓塞 

分 类 号：R364.31[医药卫生—病理学] R711.74[医药卫生—基础医学]