氨甲蝶呤孕囊内注射联合宫腔镜手术治疗子宫瘢痕妊娠患者的效果  

Effects of gestation sac injection of Methotrexate combined with hysteroscopy surgery in patients with uterine scar pregnancy

作　　者：张伟娜[1] ZHANG Weina(Department of Obstetrics and Gynecology of the Central Hospital of Jiamusi City,Jiamusi 154000 Heilongjiang,China)

机构地区：[1]佳木斯市中心医院妇产科,黑龙江佳木斯154000

出　　处：《中国民康医学》2022年第13期47-49,62,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察氨甲蝶呤孕囊内注射联合宫腔镜手术治疗子宫瘢痕妊娠(CSP)患者的效果。方法:回顾性分析2018年10月至2021年10月该院收治的65例CSP患者的临床资料,按照治疗方法不同分为对照组(n=32)和研究组(n=33)。对照组实施宫腔镜手术治疗,研究组在对照组基础上联合氨甲蝶呤孕囊内注射治疗,比较两组临床疗效、术后恢复情况、手术前后血清学指标[肌酸激酶(CK)、β-人绒毛膜促性腺激素(β-HCG)、血管内皮生长因子(VEGF)、孕酮(P)]水平及不良反应发生率。结果:研究组治疗总有效率为93.94%,高于对照组的71.88%,差异有统计学意义(P<0.05);研究组阴道流血时间、住院时间、血清β-HCG恢复时间、月经复潮时间均短于对照组,差异有统计学意义(P<0.05);术后,研究组CK、β-HCG、VEGF、P水平均低于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:氨甲蝶呤孕囊内注射联合宫腔镜手术治疗CSP患者,可提高临床疗效,缩短预后恢复时间,改善血清CK、β-HCG、VEGF、P水平,其效果优于单纯宫腔镜手术治疗。Objective: To observe effects of gestation sac injection of Methotrexate combined with hysteroscopy surgery in patients with uterine scar pregnancy(CSP). Methods: The clinical data of 65 CSP patients admitted to our hospital from October 2018 to October 2021 were retrospectively analyzed, and were divided into control group(n=32) and study group(n=33) according to different treatment methods. The control group was treated with hysteroscopy surgery, while the study group was treated with gestation sac injection of Methotrexate on the basis of that of the control group. The clinical efficacy, the postoperative recovery, the serological index levels [creatine kinase(CK), β-human chorionic gonadotropin(β-HCG), vascular endothelial growth factor(VEGF), progesterone(P)] before and after the surgery and the incidence of adverse reactions were compared between the two groups. Results: The total effective rate of treatment in the study group was 93.94%, which was higher than the control group of 71.88%, and the difference was statistically significant(P<0.05). The vaginal bleeding time, the hospitalization time, the serum β-HCG recovery time, and the menstrual recovery time in the study group were all shorter than those in the control group, and the differences were statistically significant(P<0.05). After the surgery, the levels of CK, β-HCG, VEGF and P in the study group were lower than those in the control group, and the differences were statistically significant(P<0.05). However, there was no significant difference in the incidence of complications between the two groups(P>0.05). Conclusions: Gestation sac injection of Methotrexate combined with hysteroscopy surgery in the treatment of the CSP patients can improve the clinical efficacy, shorten the prognosis and the recovery time, and improve the serum levels of CK, β-HCG, VEGF, and P. Moreover, it is superior to single hysteroscopy surgery.

关 键 词：氨甲蝶呤 孕囊 宫腔镜手术 子宫瘢痕妊娠 孕酮 不良反应 

分 类 号：R713.8[医药卫生—妇产科学]