不同治疗方法对宫颈妊娠的疗效分析  

Therapeutic effect analysis of different treatment methods on cervical pregnancy

作　　者：张焱[1] 王景美[2] 张姝[1] 

机构地区：[1]南京大学医学院附属鼓楼医院妇产科,210008 [2]南京大学医学院附属鼓楼医院病理科,210008

出　　处：《中华妇幼临床医学杂志（电子版）》2016年第6期694-698,共5页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：国家自然科学基金青年基金项目(81300499)~~

摘　　要：目的探讨不同治疗方法对宫颈妊娠的疗效。方法选择2010年1月至2015年12月,南京大学医学院附属鼓楼医院收治的26例宫颈妊娠患者的临床病历资料为研究对象。按照患者接受的治疗方法不同,将其分为A组[n=6,采用甲氨蝶呤(MTX)+米非司酮药物治疗后,再进行清宫术治疗],B组[n=6,采用子宫动脉栓塞(UAE)治疗后,再进行清宫术治疗]和C组(n=14,直接采用清宫术治疗)。采用回顾性分析方法收集3组患者的一般临床资料、术中及术后情况等,并进行统计学分析。结果①3组患者的年龄、停经时间、流产次数、阴道分娩次数、术前血清β-人绒毛膜促性腺激素(hCG)水平及孕囊长度、宽度、高度等一般临床资料比较,差异均无统计学意义(P>0.05)。②A、B、C组患者术中出血量分别为(36.7±16.3)mL、(64.2±46.2)mL、(180.0±124.4)mL,3组比较,差异有统计学意义(F=5.978,P=0.008),并且A、B组患者术中出血量均低于C组患者,差异亦均有统计学意义(P<0.05)。3组患者住院时间、术后血清β-hCG水平比较,差异均无统计学意义(P>0.05)。③A、B组无一例患者进行子宫切除术,C组14例患者中,2例患者因术中出血量过高,进行子宫切除术。结论对于宫颈妊娠,应根据患者个体情况选择不同治疗方案,在挽救患者生命的同时尽可能保留其生育功能。MTX+米非司酮,并辅以清宫术,是安全、有效的宫颈妊娠治疗方案。Objective To evaluate the therapeutic effects of different treatment methods on cervical pregnancy. Methods A total of 26 cervical pregnancy patients＇ clinical data in Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical College from January 2010 to December 2015 were selected as research subjects. According to the different treatment methods,all patients were divided into 3 groups： group A （n = 6） who received methotrexate （MTX） and mifepristone combined with abortion treatment, group B （n = 6） who received uterine arteries embolism （UAE） combined with abortion and group C （n= 14） who received abortion treatment only. The basic clinical data, intraoperative and post-operative results were collected by retrospective method and analyzed by statistical methods. Results （1）There were no significant differences among three groups in the aspects of age, amenorrhea duration, abortion times, vaginal deliveries, preoperative β-human chorionic gonadotrophin （hCG） level, and the length, width and height of the gestational sac （P〉0.05）. （2）The intraoperative blood loss volume in group A, B and C was （36.7± 16.3） mL, （64. 2±46. 2） mL and （180. 0±124.4） mL, respectively, and there was significant difference among three groups in intraoperative blood loss volume （F= 5. 978, P= 0. 008）, and both the intraoperative blood loss volume in group A and group B were lower than that in group C, and both the differences were significantly different （P〈0.05）. But there were no significant differences in hospitalization time and postoperative β-hCG level among three groups （P〉0.05）. （3）None of the patients in group A and B received hysterectomy treatment, while 2 patients in group C received hysterectomy treatment due to the high intraoperative blood loss volume among 14 patients. Conclusions As to cervical pregnancy, the choice of treatment method should be based on the patient＇s conditions, in order to save the lives of patients an

关 键 词：妊娠 异位 临床方案 治疗效果 

分 类 号：R714.22[医药卫生—妇产科学]