子宫瘢痕妊娠3种治疗方案疗效观察  

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

作　　者：张文慧[1] 李坚雄[1] 马黛 

机构地区：[1]广东省深圳市龙岗区妇幼保健院妇产科,518172

出　　处：《蚌埠医学院学报》2016年第4期496-498,501,共4页Journal of Bengbu Medical College

摘　　要：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-h CG)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-h CG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-h CG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。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-h CG）,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-h CG 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-h CG 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.

关 键 词：子宫瘢痕妊娠 子宫动脉栓塞术 甲氨蝶呤 

分 类 号：R714.22[医药卫生—妇产科学]