经阴道超声介入配合MTX与米非司酮治疗剖宫产术后瘢痕妊娠的分析  

Analysis on the effect of transvaginal ultrasound intervention combined with MTX and mifepristone on the treatment of the patients with scar pregnancy after cesarean section

作　　者：周家翠[1] 吕清媛[2] 金丽仙[1] ZHOU Jia-cui;LV Qing-yuan;JIN Li-xian(Department of Ultrasound, Lishui People's Hospital, Lishui 32300, China;Department of Obstetrics, Lishui People's Hospital Lishui 32300, China)

机构地区：[1]丽水市人民医院超声科,浙江丽水323000 [2]丽水市人民医院产科,浙江丽水323000

出　　处：《中国生化药物杂志》2017年第11期109-110,共2页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的研究经阴道超声介入配合MTX与米非司酮治疗剖宫产术后瘢痕妊娠的临床效果。方法选取2016年5月～2017年6月丽水市人民医院收治的40例剖宫产术后瘢痕妊娠患者为研究对象。对照组进行常规MTX与米非司酮治疗，肌内注射50mg/m2甲氨蝶呤，米非司酮口服，2次/d。试验组在经阴道超声引导下，向患者胎囊内注射MTX，并给予米非司酮口服治疗，根据实际情况给予清宫术或子宫动脉栓塞手术。比较分析试验组与对照组患者住院时间、治愈率和阴道失血量等临床指标。结果试验组住院时间为（9.34±3.53）d，对照组住院时间为（22.43±5.90）d，2组差异具有统计学意义（P＜0.05）。对照组阴道失血量为（173.20±10.89）mL显著多于试验组失血量的（33.87±6.54）mL，差异具有统计学意义（P＜0.05）。试验组治疗成功率为100%（20/20），显著高于对照组的80%（16/20），2组差异具有统计学意义（P＜0.05）。结论经阴道超声介入配合MTX与米非司酮治疗剖宫产术后瘢痕妊娠临床效果较为理想，可显著改善患者相关临床症状，安全性高。Objective To investigate and analyze the clinical effect of transvaginal ultrasound intervention combined with MTX and mifepristone on the treatment of the patients with scar pregnancy after cesarean section.Methods40patients with scar pregnancy after cesarean section were selected as the object of study in Lishui people's hospital from May2016to June2017.The control group was treated with conventional MTX and mifepristone,intramuscular injection of50mg/m2methotrexate,mifepristone orally,two times a day.The experimental group was injected with MTX under the guidance of transvaginal ultrasound.The patients were given oral mifepristone,and curettage or uterine artery plug was performed according to the actual situation.The hospitalization time,cure rate,vaginal blood loss in the experimental group and the control group were compared and analyzed.Results The hospitalization time in the experimental group was(9.34±3.53)d,while in the control group was(22.43±5.90)d,the difference in the two groups had statistically significant(P<0.05).The vaginal bleeding volume in the experimental group was(33.87±6.54)mL,which was significantly longer than(173.20±10.89)mL in the experimental group(P<0.05).The success rate in the control group was80%(16/20),which was significantly lower than that in the experimental group100%(20/20)(P<0.05).Conclusion The clinical effect is ideal which transvaginal ultrasound intervention combined with MTX and mifepristone were used on the treatment of cesarean scar pregnancy,it can significantly improve clinical symptoms,has high safety.

关 键 词：阴道超声介入 甲氨蝶呤 米非司酮 剖宫产术后 瘢痕妊娠 

分 类 号：R714.22[医药卫生—妇产科学]