局部注射甲氨蝶呤对于孕囊型子宫瘢痕妊娠患者β-人绒毛膜促性腺激素水平及妊娠孕囊大小的影响  

The Effects of Local Injection onβ-Human Chorionic Gonadotropin Level and Gestational Sac Size of Pregnant Women with Cystic Uterine Scar

作　　者：黄进城 蒋素贞 唐坤 李翠芬 HUANG Jin-Cheng;JIANG Su-Zhen;TANG Kun;LI Cui-Fen(Department of Gynaecology,Dongguan Gynecology1 of Songshan Lake Central Hospital,Donggnan 523110,China)

机构地区：[1]东莞市松山湖中心医院妇科,广东东莞523110

出　　处：《中国药物经济学》2022年第4期101-104,108,共5页China Journal of Pharmaceutical Economics

摘　　要：目的探讨局部注射甲氨蝶呤对于孕囊型子宫瘢痕妊娠患者β-人绒毛膜促性腺激素(β-HCG)水平及妊娠孕囊大小的影响。方法选取2018年1月至2021年1月东莞市松山湖中心医院收治的106例孕囊型子宫瘢痕妊娠患者作为研究对象,随机分为对照组与观察组,各53例。对照组肌内注射甲氨蝶呤,观察组进行超声引导下孕囊内注射甲氨蝶呤治疗。比较两组治疗效果、各项指标恢复情况、雌激素水平、不良反应。结果对照组、观察组治疗有效率分别为84.9%、96.2%,与对照组比较,观察组治疗有效率更高(P<0.05);与对照组比较,观察组孕囊消失、月经恢复、β-HCG转阴时间更短,阴道出血、甲氨蝶呤使用次数、转清宫术治疗发生率更低,差异有统计学意义(P<0.05);治疗前,两组孕酮(P)、雌二醇(E_(2))、β-HCG、促卵泡激素(FSH)、促黄体素(LH)、孕囊大小比较,差异无统计学意义(P>0.05);治疗后,两组P、E_(2)、β-HCG、FSH、LH、孕囊大小降低,且观察组低于对照组,差异有统计学意义(P<0.05);对照组、观察组不良反应发生率分别为15.1%、3.8%,与对照组比较,观察组不良反应发生率更低(P<0.05)。结论对孕囊型子宫瘢痕妊娠患者进行超声引导下孕囊内注射甲氨蝶呤治疗,效果理想,可改善患者雌激素水平,缩小孕囊直径,且不良反应发生率低,利于改善患者预后,具有非常高的临床应用价值。Objective To explore the effects of local injection onβ-Human chorionic gonadotropin(β-HCG)level and gestational sac size of pregnant women with cystic uterine scar.Methods A total of 106 pregnant women with cystic uterine scar admitted to Songshan Lake Central Hospital in Dongguan from January 2018 to January 2021 were selected as the research objects,and were randomly divided into control group and observation group,with 53 cases in each group.The control group was intramuscular injected with methotrexate,and the observation group was intravenously injected with methotrexate under ultrasound guidance.Treatment effect,recovery of various indexes,estrogen level and adverse reactions were compared between the two groups.Results The effective rate of control group and observation group was 84.9%and 96.2%,respectively.Compared with the control group,the effective rate of observation group was higher(P<0.05).Compared with the control group,the time of pregnancy sac disappearance,menstrual recovery,β-HCG turning negative was shorter in the observation group,and the incidence of vaginal bleeding,the number of methotrexate use and uterine clearing was lower in the observation group,with statistical significance(P<0.05).Before treatment,there were no significant differences in progesterone(P),estradiol(E_(2)),β-HCG,follicle-stimulating hormone(FSH),luteinizing hormone(LH)and pregnancy sac size between 2 groups(P>0.05).After treatment,the size of P,E_(2),β-hCG,FSH,LH and pregnancy sac decreased in both groups,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).The incidence of adverse reactions in the control group and observation group was15.1%and 3.8%,respectively,and the incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion Ultrasound guided injection of methotrexate into the pregnancy capsule for patients with scar pregnancy has an ideal effect,which can improve the level of estrogen and reduc

关 键 词：局部注射 甲氨蝶呤 子宫瘢痕妊娠 Β-人绒毛膜促性腺激素 妊娠孕囊大小 

分 类 号：R714.2[医药卫生—妇产科学] R984[医药卫生—临床医学]