超声引导下妊娠囊内注射甲氨蝶呤联合超声引导下清宫术对剖宫产瘢痕妊娠患者的治疗效果  

Effect of Ultrasound-guided Intracapsular Injection of Methotrexate Combined with Ultrasound-guided Uterine Debridement in Patients with Cesarean Scar Pregnancy

作　　者：王宇辰 黄如亮 仇夏 WANG Yuchen;HUANG Ruliang;QIU Xia(Department of Gynecology,Xuzhou Maternal and Child Health Hospital,Xuzhou,Jiangsu Province,221006 China;Department of Emergency Medicine,Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu Province,221006 China)

机构地区：[1]徐州市妇幼保健院妇科,江苏徐州221006 [2]徐州医科大学附属医院急诊医学科,江苏徐州221006

出　　处：《系统医学》2022年第20期34-37,43,共5页Systems Medicine

摘　　要：目的探讨超声引导下妊娠囊内注射甲氨蝶呤联合超声引导下清宫术治疗剖宫产瘢痕妊娠(cesarean scars pregnancy,CSP)患者的临床效果。方法选取2019年2月—2020年10月在徐州市妇幼保健院治疗的80例CSP患者为研究对象,采用随机数表法分为对照组和研究组,各40例。两组患者入院后分别给予常规检查,对照组患者采用甲氨蝶呤肌肉注射联合超声引导下清宫术治疗,观察组患者采用超声引导下甲氨蝶呤妊娠囊内注射联合超声引导下清宫术治疗。比较两组临床疗效、治疗情况、恢复情况、治疗费用、不良反应情况。结果研究组总有效率(97.50%)高于对照组(80.00%),差异有统计学意义(χ^(2)=4.507,P<0.05);术后7d、术后14d研究组血清人绒毛膜促性腺激素(β-HCG)水平分别为(332.58±31.92)、(68.37±6.84)IU/L,均低于对照组,差异有统计学意义(t=22.344、37.655,P<0.05);术后,研究组患者β-HCG水平恢复到正常时间(24.09±3.85)d、月经恢复时间(38.96±3.89)d、住院时间(11.94±2.24)d均短于对照组,术中出血量(75.72±4.65)mL、住院费用(4668.49±630.50)元均少于对照组,差异有统计学意义(t=14.569、7.255、9.296、32.435、7.248,P<0.05);研究组不良反应发生率(7.50%)低于对照组(25.00%),差异有统计学意义(χ^(2)=4.501,P<0.05)。结论超声引导下妊娠囊内注射甲氨蝶呤联合超声引导下清宫术治疗剖宫产瘢痕妊娠患者临床效果显著,可有效降低β-HCG水平,且术中出血量少,住院时间短、住院费用低,术后康复快,不良反应少,值得应用。Objective To investigate the clinical effect of ultrasound-guided intra-pregnancy sac injection of methotrexate combined with ultrasound-guided uterine clearance in the treatment of patients with cesarean scar pregnancy(CSP).Methods 80 patients with CSP treated in Xuzhou Maternal and Child Health Hospital from February 2019 to October 2020 were selected as the research object.The random number table method was used to divide the patients into control group and study group,40 cases each.Patients in both groups were given routine examination after admission,and patients in the control group were treated with methotrexate intramuscular injection combined with ultrasound-guided clearing,while patients in the observation group were treated with methotrexate intragestational capsule injection combined with ultrasound-guided clearing under ultrasound.The clinical efficacy,treatment,recovery,treatment cost and adverse reactions of the two groups were compared.Results The total effective rate of the study group(97.50%)was higher than that of the control group(80.00%),and the difference was statistically significant(χ^(2)=4.507,P<0.05).The serum human chorionic gonadotropin(β-HCG)levels in the study group were(332.58±31.92)IU/L and(68.37±6.84)IU/L at 7 d and 14 d postoperatively,respectively,which were lower than those in the control group,and the differences were statistically significant(t=22.344,37.655,P<0.05).After surgery,the time to returnβ-HCG level to normal(24.09±3.85)d,the time to resume menstruation(38.96±3.89)d,and the hospitalization time(11.94±2.24)d were shorter in the study group than in the control group,and the intraoperative bleeding volume(75.72±4.65)mL and hospitalization cost(4668.49±630.50)yuan were less than in the control group,with differences were statistically significant(t=14.569,7.255,9.296,32.435,7.248,P<0.05).The incidence of adverse reactions in the study group(7.50%)was lower than that in the control group(25.00%),and the difference was statistically significant(χ^(2)=4.501,P<0.

关 键 词：甲氨蝶呤 妊娠囊内注射 瘢痕妊娠 超声引导下清宫术 血清人绒毛膜促性腺激素 

分 类 号：R714[医药卫生—妇产科学]