妊娠囊内注射甲氨蝶呤联合水囊压迫对Ⅱ型剖宫产疤痕妊娠卵巢功能的影响  

Protective effects of intracapsular injection methotrexate combined aqueous capsule compression on ovarian function in pretreatment of uterine curettage for patients with typeⅡcesarean scar pregnancy

作　　者：吴晶晶 刘岩 陈琪珍 陈雄 WU Jing-jing;LIU Yan;CHEN Qi-zhen;CHEN Xiong(Department of Obstetrics and Gynecology,Wusong Central Hospital of Boshan District,Shanghai 200940,China)

机构地区：[1]上海市宝山区吴淞中心医院妇产科,上海200940

出　　处：《医药论坛杂志》2023年第5期56-59,64,共5页Journal of Medical Forum

基　　金：上海市卫生健康委先进适宜技术推广项目(2019SY066)。

摘　　要：目的探讨孕囊内注射甲氨蝶呤(methotrexate,MTX)联合水囊压迫对II型剖宫产痕痕妊娠患者卵巢功能的影响。方法回顾性分析2018年1月至2020年12月上海市宝山区吴淞中心医院吴淞中心医院确诊的48例II型剖宫产疤痕妊娠患者的临床资料,将22例行子宫动脉栓塞术+清宫术者纳入对照组,26例行妊娠囊内注射MTX+水囊压迫+清宫术者纳入试验组。比较两组患者术后HCG恢复情况、术后月经恢复情况、术后1个月、3个月、6个月、12个月抗苗勒管激素(AMH)、窦卵泡计数(AFC)、卵泡刺激素(FSH)、黄体生成素(LH)的变化。结果试验组患者术后HCG恢复情况、术后的月经恢复时间明显短于对照组,差异均有统计学意义(P<0.05);术后1个月、3个月、6个月,试验组患者的AFC、AMH明显高于对照组,FSH值、FSH/LH比值明显低于对照组,差异均有统计学意义(P<0.05);术后12个月,试验组与对照组患者的AFC、AMH、FSH、FSH/LH比较差异均无统计学意义(P>0.05)。结论孕囊内注射MTX联合水囊压迫治疗Ⅱ型剖宫产痕痕妊娠患者对卵巢功能影响小,值得临床推广应用。Objective To compare the effects of two pretreatment methods of uterine curettage on ovarian function for patients with type Ⅱ cesarean scar pregnancy.One is intracapsular injection methotrexate combined with aqueous capsule compression,and the other is uterine artery embolization followed by uterine curettage.Methods From January 2018 to December 2020,48 patients with type II cesarean scar pregnancy were treated in our hospital,who were divided into treatment group and the control group according to the different treament methods.Patients in the treatment group(n=26)received intracapsular injection methotrexate combined with aqueous capsule compression before uterine curettage and patients in the control group(n=22)received uterine artery embolization followed by uterine curettage.Results It took less time for the recovery of menstrual function for patients in the treatment group than those in the control group(P<0.05).The level of AFC and AMH of the patients in the treatment group were significantly higher than that in the control group at 1 month,3 months and 6 months after surgery(P<0.05).The level of FSH and the ratio of FSH/LH in the treatment group were significantly lower than that in the control group(P<0.05).At 12 months after surgery,there were no significant diferences between the treatment group and the control group over the level of AFC,AMH,FSH,FSH/LH(P>0.05).Conclusion The pretreatment of intracapsular injection methotrexate combined with aqueous capsule compression demonstrated a protective effect on ovarian cancer compared with uterine artery embolization followed by uterine curettage for patients with type Ⅱ cesarean scar pregnancy.This method deserves to be Objective To compare the effects of two pretreatment methods of uterine curettage on ovarian function for patients with type Ⅱ cesarean scar pregnancy.One is intracapsular injection methotrexate combined with aqueous capsule compression,and the other is uterine artery embolization followed by uterine curettage.Methods From January 201

关 键 词：剖宫产疤痕妊娠 子宫动脉栓塞 水囊压迫 抗苗勒管激素 窦卵泡数 卵泡刺激素 

分 类 号：R719.8[医药卫生—妇产科学]