子宫动脉栓塞与肌注甲氨蝶呤分别联合清宫术治疗剖宫产术后切口妊娠临床疗效对比分析  

Clinical efficacy of uterine artery embolization and methotrexate combined with intramuscular injection in the treatment of incisional pregnancy after cesarean section

作　　者：胡晓丽[1] 籍霞[1] 李萍[1] 王海波[1] 甄银芝[1] 高丽彩[1] 武子先 韩慈[1] 李艳丽[2] HU Xiaoli;JI Xia;LI Ping;WANG Haibo;ZHEN Yinzhi;GAO Licai;WU Zixian;HAN Ci;LI Yanli(Department of Obstetrics and Gynecology, The 260th Hospital of PLA, Shijiazhuang 050041, China)

机构地区：[1]解放军第260医院妇产科,石家庄050041 [2]解放军第260医院病理科,石家庄050041

出　　处：《空军医学杂志》2018年第6期398-400,418,共4页Medical Journal of Air Force

基　　金：河北省卫生和计划生育委员会重点项目计划(20171529)

摘　　要：目的探讨子宫动脉栓塞与肌注甲氨蝶呤分别联合清宫术治疗剖宫产术后切口妊娠临床疗效对比分析。方法回顾性分析2016年10月—2018年2月解放军第260医院收治的82例剖宫产术后切口妊娠患者的临床资料,根据随机数字表法分为观察组和对照组,每组41例。观察组患者采用子宫动脉栓塞结合宫腔镜下清宫术治疗,对照组患者采用肌注甲氨蝶呤联合清宫术治疗,观察并对比2组患者的临床疗效,术中出血量、手术时间、阴道流血时间、住院时间、血绒毛膜促性腺激素(β-HCG)转阴时间及并发症情况和输血情况。结果观察组患者治疗后临床总有效率明显高于对照组(P<0.05);与对照组比较,观察组术中出血量少、阴道流血时间短、住院时间短、血β-HCG转阴时间短,差异具有统计学意义(P<0.05);观察组患者术后并发症发生率明显低于对照组;输血率比较差异有统计学意义(P<0.05)。结论子宫动脉栓塞结合宫腔镜下清宫术治疗剖宫产术后切口妊娠患者临床疗效显著,术后并发症情况少,更有利于术后患者的及时恢复,值得临床推广。Objective To investigate the clinical effect of uterine artery embolization and methotrexate combined with intramuscular injection respectively in the treatment of incisional pregnancy after cesarean section.Methods Eightytwo patients with cesarean scar pregnancy treated in our hospital between October 2016 and February 2018 were selected as the subjects.The clinical data of all these patients was analyzed retrospectively.These patients were divided into the observation group and control group according to treatment methods,with 41 cases in each group.The patients in the observation group were treated with intramuscular injection of methotrexate combined with curettage.The curative effect of the two groups was observed and compared after operation.The intraoperative bleeding volume,duration of surgery,vaginal bleeding time,length of hospital stay,blood HCG(β-HCG)clearance time,complications and blood transfusion were also compared between the two groups.Results The total clinical efficiency of patients in the observation group after treatment was significantly higher than that of the control group(P<0.05).Compared with the control group,the bleeding volume,vaginal bleeding,hospital stay and bloodβ-HCG clearance time in the observation group were reduced or shortened significantly(P<0.05).The incidence of postoperative complications of patients in the observation group decreased significantly compared with the control group.The intraoperative blood transfusion rates of patients in the two groups were significantly different(P<0.05).Conclusion Uterine artery embolization combined with hysteroscopy in the treatment of cesarean scar pregnancy has significant clinical effect,fewer postoperative complications,and is more conducive to recovery of patients.It is worthy of popularization in clinical practice.

关 键 词：子宫动脉栓塞 清宫术 甲氨蝶呤 剖宫产 剖宫产术后切口妊娠 

分 类 号：R719.8[医药卫生—妇产科学]