垂体后叶素处理后彩超引导下清宫术联合宫腔镜电切术治疗Ⅰ型剖宫产切口部妊娠  

Combination of pituitrin injection and color doppler ultrasound-guided curettage and hysteroscopic electrocision for treating type Ⅰ CSP

作　　者：刘婷 LIU Ting(Department of Obstetrics and Gynecologu,The First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000)

机构地区：[1]赣南医学院第一附属医院妇产科,江西赣州341000

出　　处：《赣南医学院学报》2020年第11期1127-1130,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：赣州市指导性科技计划项目(GZ2018ZSF014)。

摘　　要：目的:探讨注射垂体后叶素后行彩超引导下清宫术联合宫腔镜下电切术治疗Ⅰ型剖宫产切口部妊娠的治疗效果。方法:选取2014年6月至2019年6月就诊于我院的患者,术前经阴道彩超诊断为Ⅰ型剖宫产切口部妊娠50例,分为M及N两组,其中M组25例,采用于宫颈与宫体交界处注射垂体后叶素后行彩超引导下清宫术联合宫腔镜电切术;N组25例,采用彩超引导下氨甲蝶呤妊娠囊内注射联合口服米非司酮片治疗,待血HCG值降至100 IU·L^-1后行宫腔镜电切术,对比两组治疗效果。结果:M组术后血HCG恢复至正常时间、月经恢复正常时间、总住院时间均短于N组,M组总住院费用少于N组,差异有统计学意义(P<0.05)。M组手术时间、术中出血量与N组相比,差异无统计学意义(P>0.05)。结论:与妊娠囊内注射氨甲蝶呤联合口服米非司酮相比,垂体后叶素注射后行彩超引导下清宫术联合宫腔镜电切术治疗Ⅰ型剖宫产切口部妊娠有显著优势。Objective:To evaluate the efficacy and safety of pituitrin injecion and color doppler ultrasound-guided curettage combined Hysteroscopic electrocision for treating type Ⅰ CSP.Methods:From June 2014 to June 2019,25 patients(the M group)with type Ⅰ CSP in the first affiliated hospital of Gannan Medical University were treated with pituitrin injection and color doppler ultrasound-guided curettage combined hysteroscopic electrocision,while the other 25 patient(the N group)with type Ⅰ CSP were treated with methtrexate injection in gestational sac with color ultrasound guided and take mifepristone orally followed by hysteroscopic electrocision.The clinical data were analyzed with statistics to compare the efficacy and safety between the two groups.Results:The time when serumβ-HCG return to the normal range and the recovery time of menstruation after hospital discharge,the total hospitalization duration in M group were shorter than that in the N group(P<0.05).The total hospitalization expenses in the M group were lower than that in the N group(P<0.05).There was no significant difference in the average operative duration,the intraoperative blood loss between the two groups(P>0.05).Conclusion:Combination of pituitrin injection and color doppler ultrasound-guided curettage and hysteroscopic electrocision for treating type Ⅰ CSP possesses an apparent advantage over methtrexate injection in gestational sac followed by hysteroscopic electrocision.It may be a priority option for type Ⅰ CSP.

关 键 词：剖宫产切口部妊娠 清宫术 宫腔镜 垂体后叶素 氨甲蝶呤 

分 类 号：R719.8[医药卫生—妇产科学]