超声引导下甲氨蝶呤介入治疗瘢痕妊娠的疗效分析  

The clinical effect of ultrasound-guided interventional therapy with local methotrexate for cesarean sear pregnancy

作　　者：姜艳丽[1] 贺秀红[1] 曲俊朴[1] Jiang Yanli;He Xiuhong;Qu Junpu(Department of Ultrasound,ErdosCenter Hospital,Inner Mongolia 017000,China)

机构地区：[1]内蒙古自治区鄂尔多斯市中心医院超声科,017000

出　　处：《实用医学影像杂志》2020年第4期362-365,共4页Journal of Practical Medical Imaging

摘　　要：目的评价超声引导下妊娠囊周边局部注射甲氨蝶呤(MTX)在瘢痕妊娠(CSP)治疗中的疗效。方法回顾分析我院2014年7月至2019年2月收治的剖宫产术后子宫瘢痕妊娠患者54例,按不同治疗方案分为超声介入治疗组(28例)和子宫动脉栓塞(UAE)介入治疗组(26例),分析2组的治愈率、出血量、人绒毛膜促性腺激素(β-hCG)降至正常的时间、住院时间等,评价临床疗效。结果超声介入治疗组与动脉栓塞治疗组比较差异无统计学意义(P>0.05),2组阴道出血量、血β-hCG降至正常的时间及住院时间比较差异无统计学意义(P>0.05),但动脉栓塞组有4例出现了不良反应而超声介入没有。术后随访两组治愈患者月经都已恢复,且超声介入组有2例患者再次正常妊娠并足月生产。结论对于CSP的治疗超声介入治疗组可以与动脉栓塞组相媲美,且无副反应,无麻醉手术风险,无高额费用,故超声介入治疗更安全、经济、微创,更值得推广。Objective To investigate the efficacy of ultrasound-guided local injection of methotrexate(MTX)as a treatment for cesarean scar pregnancy(CSP).Methods Retrospectivey analyze 54 patients with CSP from July 2014 to February 2019 in our hospital.According to different treatment options,the patients were divided into the ultrasound intervention group(28 patients)and the uterine artery embolization(UAE)intervention group(26 patients).The cure rate,blood loss,time for serumβ-hCG normalization and hospitalization time were analyzed to evaluate the clinical efficacy.Results There was no significant difference between the ultrasound intervention group and UAE group(P>0.05).There was no significant difference in the amount of vaginal bleeding、hospitalization time and for serumβ-hCG normalization between the two group(P>0.05).However,there were 4 cases of side effects in the UAE group and no ultrasound intervention.After follow-up,the menstruation of the two group′s patients cured recovered,and two patients had normal full-term pregnancy in the ultrasound intervention group.Conclusion The ultrasound interventional treatment group for CSP can be compared with the UAE group.However,There is no side effects,no risk of anesthesia and surgery,no high cost,so ultrasound interventional treatment is safer,more economical,minimally invasive,and worth promoting.

关 键 词：超声检查 甲氨蝶呤 妊娠 

分 类 号：R714.22[医药卫生—妇产科学]