匀速低剂量氨甲蝶呤动脉灌注栓塞术终止非急性出血瘢痕妊娠  

Termination of non-acute bleeding cesarean scar pregnancy with arterial infusion and embolization with low-dosage methotrexate at constant speed

作　　者：刘名利 刘志华 谭莹 符国平 邝明涛 岳振东[4] 

机构地区：[1]湘潭县妇幼保健院放射科,湖南湘潭411228 [2]湘潭县人民医院放射科,湖南湘潭411228 [3]湘潭县妇幼保健院妇科,湖南湘潭411228 [4]首都医科大学附属北京世纪坛医院介入治疗科,北京100038

出　　处：《中国介入影像与治疗学》2016年第7期398-401,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨匀速低剂量氨甲蝶呤(MTX)动脉灌注栓塞术在终止非急性出血瘢痕妊娠(CSP)中的应用价值。方法回顾性分析诊断明确、经MTX动脉灌注栓塞治疗有效且成功接受清宫术的非急性出血CSP患者47例,接受人工手动常规剂量MTX动脉灌注栓塞术治疗患者22例(A组),接受匀速低剂量MTX动脉灌注栓塞术治疗患者25例(B组)。比较两组MTX使用量、灌注时间、术后3天血人绒毛膜促性腺激素(β-HCG)、血β-HCG恢复正常时间、月经恢复时间、清宫术中出血量。结果 B组较A组MTX使用量明显减少,灌注时间延长,术后3天血β-HCG值明显下降,恢复正常时间明显缩短,月经恢复时间缩短,清宫术中出血量明显减少,两组差异均有统计学意义(P均<0.05)。结论匀速低剂量MTX动脉灌注栓塞术在终止非急性出血CSP中,可明显减少MTX用量,是一种安全、有效的治疗方法。Objective To discuss the application values of arterial infusion and embolization with low-dosage Methotrexate （MTX） at constant speed in termination of non-acute bleeding cesarean scar pregnancy （CSP）. Methods A total of 47 non-acute bleeding CSP patients, who were clearly diagnosed, effectively treated with MTX arterial infusion and embolism and successfully received complete curettage of uterine cavity, were retrospectively analyzed. Among all the patients, 22 patients （group A） were treated with arterial infusion and embolism with conventional dosage in an artificial rate, and 25 patients （group B） received arterial infusion and embolism with low-dosage MTX at constant speed. Administered dosages of MTX, perfusion time, blood β-human chorionic gonadotropin （β-HCG） 3 days post-operative, blood β-HCG recovery time, recovery time of menstruation, amount of bleeding during curettage were analyzed between the two groups. Results Compared with A group, administered dosages of MTX was significantly lower, perfusion time was longer, blood β-HCG 3 days post-operative decreased significantly and durations for postoperative recover was obviously shorter, the amount of bleeding during curettage decreased in group B, which all had significant differences （all P〈0.05）. Conclusion Arterial infusion and embolism with low-dosage MTX at constant speed can significantly reduce administered dosage of MTX in terminations of non-acute bleeding CSP, which is a safe and effective therapy method.

关 键 词：剖宫产 妊娠 子宫动脉 栓塞 治疗性 氨甲蝶呤 

分 类 号：R714.22[医药卫生—妇产科学]