甲氨蝶呤联合平阳霉素双侧子宫动脉灌注治疗剖宫产瘢痕妊娠疗效及安全性研究  

Efficacy and Safety of Bilateral Uterine Artery Infusion of Methotrexate and Pingyangmycin in the Treatment of Patients with Cesarean Scar Pregnancy

作　　者：崔雪娇 李英 范玖香 CUI Xuejiao;LI Ying;FAN Jiuxiang(Qinhuangdao Military Hospital,Qingdao,Heibei,China066000;Port Hospital of Hebei Port Group Co.,Ltd.,Qingdao,Heibei,China066000)

机构地区：[1]秦皇岛军工医院,河北秦皇岛066600 [2]河北港口集团有限公司港口医院,河北秦皇岛066000

出　　处：《中国药业》2021年第6期71-73,共3页China Pharmaceuticals

基　　金：河北省医学科学研究课题[20201309]。

摘　　要：目的探讨双侧子宫动脉灌注甲氨蝶呤及平阳霉素治疗剖宫产瘢痕妊娠(CSP)的临床疗效,以及对阴道出血情况的影响。方法选取秦皇岛军工医院2018年5月至2020年1月收治的CSP孕妇102例,随机分为观察组和对照组,各51例。两组患者均予注射用甲氨蝶呤,观察组患者加用注射用盐酸平阳霉素,均双侧子宫动脉灌注给药,每日1次,治疗1周。结果观察组总有效率为92.16%,显著高于对照组的76.47%(P <0.05);观察组患者在治疗后的第1,3,6,12天的β-人绒毛膜促性腺激素(β-HCG)水平均显著低于对照组(P <0.05);治疗期间,观察组患者的阴道出血量显著少于对照组,出血停止时间显著短于对照组(P <0.05);随访期间,观察组患者的孕囊消失时间、β-HCG复常时间、月经复常时间均显著短于对照组(P <0.05);观察组与对照组不良反应发生率相当(13.73%比9.80%,P=0.290> 0.05)。结论甲氨蝶呤联合平阳霉素双侧子宫动脉灌注治疗CSP,能迅速降低患者的β-HCG水平,减少阴道出血,改善预后。Objective To investigate the clinical efficacy of bilateral uterine artery infusion of methotrexate and pingyangmycin in the treatment of patients with cesarean scar pregnancy(CSP)and its effect on vaginal bleeding.Methods Totally 102 pregnant women with CSP admitted to the Qinhuangdao Military Hospital from May 2018 to January 2020 were selected and randomly divided into the observation group and the control group,51 cases in each group.The patients in the two groups were treated with Methotrexate for Injection,on this basis,the patients in the observation group were treated with Pingyangmycin Hydrochloride for Injection,all the patients were administrated by bilateral uterine artery infusion for one week with once a day.Results The total effective rate of the observation group was 92.16%,which was significantly higher than 76.47%of the control group(P<0.05).The level ofβ-human chorionic gonadotropin(β-hCG)in the observation group was significantly lower than that in the control group on the first,third,sixth and twelfth day after treatment(P<0.05).During the treatment,the amount of vaginal bleeding in the observation group was significantly less than that in the control group,and the bleeding stop time in the observation group was significantly shorter than that in the control group(P<0.05).During the follow-up period,the gestational sac disappearance time,β-h CG normalization time and menstrual normalization time in the observation group were significantly shorter than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was similar to that in the control group(13.73%vs.9.80%,P=0.290>0.05).Conclusion Bilateral uterine artery infusion of methotrexate and pingyangmycin in the treatment of patients with CSP can rapidly improve the level ofβ-h CG,reduce vaginal bleeding and improve the prognosis.

关 键 词：剖宫产瘢痕妊娠 子宫动脉灌注 甲氨蝶呤 平阳霉素 Β-人绒毛膜促性腺激素 临床疗效 

分 类 号：R969.4[医药卫生—药理学] R984[医药卫生—药学]