宫腔镜术前MTX两种给药方式对剖宫产术后瘢痕妊娠患者出血量、血β-hCG水平及相关并发症的影响  

Effects of two administration ways of methotrexate before hysteroscopic surgery on the amount of blood loss,blood β-human chorionic gonadotropin levels and related complications of caesarean scar pregnancy

作　　者：张友国[1] 

机构地区：[1]阜阳市人民医院,安徽阜阳236000

出　　处：《中国妇幼保健》2017年第8期1777-1779,共3页Maternal and Child Health Care of China

基　　金：江苏省中医药局科技项目(LZ13176)

摘　　要：目的探讨术前甲氨喋呤(MTX)静脉滴注和经子宫动脉栓塞给药对行宫腔镜手术剖宫产术后瘢痕妊娠(CSP)患者出血量、血β-hCG水平及围手术期并发症的影响。方法选取CSP患者100例,采用随机数字表法分为A组(50例)和B组(50例),分别在宫腔镜术前采用MTX静脉滴注与经子宫动脉栓塞给药治疗;比较两组患者术中和术后出血量、血β-hCG水平和月经复常时间,治疗前后瘢痕妊娠病灶直径及围手术期并发症发生率等。结果 B组患者术中和术后出血量均显著少于A组(P<0.05);B组患者血β-hCG水平和月经复常时间均显著短于A组(P<0.05);B组患者宫腔镜术前瘢痕妊娠病灶直径显著短于A组(P<0.05);B组患者手术前后血β-hCG水平显著低于A组(P<0.05);同时B组患者围手术期并发症发生率明显低于A组(P<0.05)。结论相较于静脉滴注给药,MTX经子宫动脉栓塞给药用于治疗宫腔镜手术CSP,可显著减少围手术期出血量,促进血β-hCG水平和月经复常,有助于降低相关并发症发生风险。Objective To explore the effects of intraveuous drip and uterine artery embolization of methotrexate （MTX） before hystero- scopic surgery on the amount of blood loss, blood β-human chorionic gonadotropin （β-hCG） levels and related perioperative complications of caesarean scar pregnancy （CSP） . Methods One hundred patients with CSP were selected, then they were divided into A group （50 patients） and B group （50 patients） according to random number table, the patients in the two groups were treated by intravenous drip and u- terine artery embolization of MTX before hysteroscopic surgery, respectively. The amounts of blood loss during and after surgeD＇, the recovery time of blood β-hCG levels and menstruation, the diameter of lesion before treatment, the incidence rates of perioperative complications in the two groups were compared. Results The amounts of blood loss during and after surgery in B group were statistically significantly lower than those in A group （ P〈0.05 ） . The recovery, time of blood β-hCG levels and menstruation in B group was statistically significantly shor- ter than that in A group （ P〈0. 05 ） . The diameter of lesion before treatment in B group was statistically significantly less than that in A group （ P〈0. 05 ） . The levels of blood β-hCG before and after surgery in B group were statistically significantly lower than those in A group （P〈0. 05） . The incidence rates of perioperative complications in B group were statistically significantly lower than those in A group （ P〈 0. 05） . Conclusion Compared with MTX intravenous drip in treatment of patients with CSP, uterine artery embolization of MTX can sig- nificantly reduce the amount of blood loss during perinperative period, promote recovery of blood β-bCG levels and menstruation, and reduce the risk of related perioperative eomplications.

关 键 词：MTX 静脉滴注 子宫动脉栓塞 宫腔镜 CSP 

分 类 号：R713.4[医药卫生—妇产科学]