瘢痕妊娠三种治疗方式的临床分析  

Clinical Analysis of Three Treatment Methods for Scar Pregnancy

作　　者：王志敏 刘志强[1] 郭庆枝[1] 石洪堂 WANG Zhi-min;LIU Zhi-qiang;GUO Qing-zhi;SHI Hong-tang(Affiliated Hospital of Binzhou Medical College,Binzhou,256600,China)

机构地区：[1]滨州医学院附属医院,山东滨州256600

出　　处：《西北民族大学学报（自然科学版）》2020年第1期41-44,共4页Journal of Northwest Minzu University(Natural Science)

摘　　要：目的:研究三种治疗瘢痕妊娠的疗效,为临床治疗提供依据.方法:选择2014年10月1日~2018年10月31日滨州医学院附属医院收入院的瘢痕妊娠患者152例,分三组,分别为Ⅰ组(单纯清宫术)84例,Ⅱ组(米非司酮联合清宫术)31例,Ⅲ组(甲氨蝶呤MTX+米非司酮联合清宫术)37例.手术后24 h血HCG下降的速率,HCG降至正常所需的时间,住院的花费,住院的时间进行了比较.结果:Ⅲ组中手术后24 h血HCG下降的速率、HCG降至正常所需的时间,明显优于Ⅰ组、Ⅱ组,对比差异有显著性,具有统计学意义(P<0.05),在住院花费、住院时间方面,三组之间无显著性差异,没有统计学意义(P>0.05).三组中治疗的有效率(按照原治疗方案顺利出院的患者与原方案总患者比例的百分比)分别为85%、81%、97%,Ⅲ组分别与Ⅰ组、Ⅱ组的有效率有显著性差异,有统计学意义(P<0.05),Ⅰ组与Ⅱ组的有效率无显著性差异,无统计学意义(P>0.05).结论:采用甲氨蝶呤+米非司酮+清宫术治疗瘢痕妊娠在手术后24 h血HCG下降率、HCG下降至正常所需的时间及有效率方面效果优于清宫术及米非司酮+清宫术,在临床中更值得应用.Objective In order to study the effect of three treatment methods on scar pregnancy.Methods 152 patients with scar pregnancy admitted to binzhou medical college affiliated hospital from October 1,2014 to October 31,2018 were selected and divided into three groups:84 patients in group Ⅰ(simple hysterectomy),31 patients in group Ⅱ(mifepristone combined with hysterectomy)and 37 patients in group Ⅲ(MTX+ mifepristone combined with hysterectomy).The rate at which blood HCG decreased 24 hours after surgery,the time it took for HCG to return to normal,the cost of hospitalization,and the length of hospitalization were compared.Results the rate of HCG decrease and the time required for HCG reduction to normal 24 hafter surgery in group Ⅲ were significantly better than those in group I and Ⅱ,with statistically significant difference(P<0.05).There was no significant difference between the three groups in terms of hospitalization cost and duration(P>0.05).The effective rate(the percentage of patients discharged according to the original treatment plan and the total patients in the original treatment plan)of the three groups was 85%,81%and 97%,respectively.The effective rate difference between group Ⅲ and group Ⅰ and Ⅱ was statistically significant(P<0.05),while the effective rate difference between group I and Ⅱ was not statistically significant(P>0.05).Conclusion Treatment of scar pregnancy with methotrexate+mifepristone+palace cleaning is better than that of palace cleaning and mifepristone+palace cleaning in terms of blood HCG decline rate,time required for HCG to drop to normal and effective rate 24 hafter surgery,and the effect is better,which is more worthy of application in clinical work.

关 键 词：米非司酮 甲氨蝶呤 清宫术 瘢痕妊娠 

分 类 号：R714.32[医药卫生—妇产科学]