甲氨蝶呤联合高强度聚焦超声对剖宫产瘢痕妊娠患者的治疗效果及对β-人绒毛膜促性腺激素、降钙素原水平的影响  

Therapeutic effect of methotrexate combined with high-intensity focused ultrasound on cesarean scar preg-nancy and influence on the levels ofβ-HCG and procalcitonin

作　　者：赵倩 严凤[1] 李全香[1] ZHAO Qian;YAN Feng;LI Quanxiang(Department of Gynecology,Baoding Maternal and Child Health Hospital,Baoding 071000,Hebei,China)

机构地区：[1]保定市妇幼保健院妇科,河北保定071000

出　　处：《中国性科学》2021年第3期58-61,共4页Chinese Journal of Human Sexuality

基　　金：保定市科学技术研究与发展指导计划(18ZF273)。

摘　　要：目的研究甲氨蝶呤联合高强度聚焦超声(HIFU)治疗剖宫产瘢痕妊娠的效果及对β-人绒毛膜促性腺激素(β-HCG)、降钙素原(PCT)水平的影响。方法选取2017年6月至2019年5月保定市妇幼保健院诊治的70例剖宫产瘢痕妊娠患者作为研究对象。按照不同治疗方法将患者分为HIFU组(n=35)和联合组(n=35)。HIFU组实施HIFU治疗,联合组在HIFU组基础上给予甲氨蝶呤。检测β-HCG、PCT、超敏C反应蛋白(hs-CRP)水平,采用视觉模拟评分法(VAS)评分评估患者疼痛程度,统计治疗效果及并发症情况。结果治疗后,联合组β-HCG水平、VAS评分、PCT水平、hs-CRP水平均低于HIFU组,差异具有统计学意义(P<0.05)。联合组月经恢复正常时间、阴道出血时间、β-HCG下降至正常时间均短于HIFU组,包块大小小于HIFU组,差异具有统计学意义(P<0.05)。联合组治疗总有效率高于HIFU组,差异具有统计学意义(P<0.05)。联合组并发症发生率低于HIFU组,但差异无统计学意义(P>0.05)。结论甲氨蝶呤联合HIFU对剖宫产瘢痕妊娠患者的治疗效果显著,月经恢复时间短,可有效降低β-HCG和PCT水平,减轻患者疼痛。Objective To study the effect of methotrexate combined with high-intensity focused ultrasound(HIFU)in the treatment of cesarean scar pregnancy and its influence onβ-HCG and PCT.Methods 70 patients with cesarean scar pregnancy in the Baoding Maternal and Child Health Hospital from June 2017 to May 2019 were selected and divided into HIFU group(n=35)and combined group(n=35)according to different treatment meth-ods.HIFU group was given HIFU treatment,combined group was given methotrexate on the basis of HIFU group.The levels of serumβ-human chorionic gonadotropin(β-HCG),procalcitonin(PCT)and hypersensitive C-reactive protein(hs-CRP)were detected,and the visual analogue scale(VAS)score was performed.The treatment effi-ciency and the incidence of complications were counted.Results After treatment,β-HCG level,VAS score,PCT level and hs-CRP level in the combined group were lower than those in the HIFU group(P<0.05).The menstrual recovery time,vaginal bleeding time andβ-HCG decrease to normal time in the combined group were all shorter than those in the HIFU group,and the mass size was smaller than that in the HIFU group,the difference was statis-tically significant(P<0.05).The total effective rate of the combined group was higher than that of the HIFU group,and the difference was statistically significant(P<0.05).The incidence of complications in the combined group was lower than that in the HIFU group,but the difference was not statistically significant(P>0.05).Conclusions Methotrexate combined with HIFU has a significant therapeutic effect on patients with caesarean scar pregnancy.The menstrual recovery time is short,and it can effectively reduce the levels ofβ-HCG and PCT,and relieve the pain of patients.

关 键 词：甲氨蝶呤 高强度聚焦超声 剖宫产瘢痕妊娠 月经恢复 

分 类 号：R714[医药卫生—妇产科学]