子宫动脉栓塞联合甲氨蝶呤及宫孕方对瘢痕妊娠患者清宫术出血情况β-人绒毛膜促性腺激素及月经恢复时间的影响  

Effects of uterine artery embolization combined with methotrexate and uterine pregnancy formula on bleeding during curettage,β-HCG recovery time,and menstrual recovery time in patients with scarred pregnancy

作　　者：张秀萍 徐菲菲 张琳 潘莎莎 Zhang Xiuping;Xu Feifei;Zhang Lin;Pan Shasha(Department of Obstetrics and Gynecology,Ninghai County First Hospital,Ningbo,Zhejiang 315600,China)

机构地区：[1]宁海县第一医院妇产科,浙江宁波315600

出　　处：《中国药物与临床》2024年第19期1264-1268,共5页Chinese Remedies & Clinics

摘　　要：目的探讨子宫动脉栓塞术(UAE)联合甲氨蝶呤及宫孕方对剖宫产瘢痕妊娠(CSP)清宫术出血量、β-人绒毛膜促性腺激素(β-HCG)水平及月经恢复正常时间的影响。方法选取浙江省宁海县第一医院2018年1月至2021年1月收治的66例CSP患者,收集其基线资料,按治疗方法将患者分为2组,其中29例行UAE+清宫术+甲氨蝶呤+宫孕方(观察组),37例行UAE+清宫术(对照组)。统计分析2组围术期指标、β-HCG水平与月经恢复正常时间以及不良反应发生率。结果66例CSP患者年龄(34±4)岁,β-HCG水平(25125±3784)U/L、月经恢复时间(3.8±0.8)个月。观察组患者住院时间、术中出血量及阴道出血持续时间均少于对照组(P<0.05)。观察组患者血清β-HCG水平恢复正常时间和月经恢复正常时间均短于对照组(P<0.05)。观察组不良反应总发生率为10%,对照组不良反应总发生率为16%,差异无统计学意义(P>0.05)。结论子宫动脉栓塞联合甲氨蝶呤及宫孕方可有效减少CSP患者清宫术出血量,缩短β-HCG水平恢复正常时间和月经恢复正常时间,值得临床推广应用。Objective To investigate the effects of uterine artery embolization(UAE)combined with methotrexate and uterine pregnancy formula on the amount of bleeding,β-human chorionic gonadotropin(β-HCG)levels,and menstrual recovery time during cesarean section scar pregnancy(CSP)curettage.Methods A total of 66 CSP patients admitted to the First Hospital of Ninghai County from January 2018 to January 2021 were selected,and their baseline data were collected.The patients were divided into an observation group(29 cases,under-going UAE+curettage surgery+methotrexate+uterine pregnancy formula)and a control group(37 cases,undergo-ing UAE+curettage surgery)depending on treatment methods.The perioperative indicators,β-HCG levels,menstrual recovery time,and incidence of adverse reactions of the two groups were statistically analyzed.Results The age of 66 CSP patients was(34±4)years old,with HCG levels of(25125±3784)U/L and menstrual recovery time of(3.8±0.8)months.The hospitalization time,intraoperative bleeding volume,and duration of vaginal bleeding in the observation group were significantly less than those in the control group(P<0.05).The recovery time of serumβ-HCG levels and menstrual cycle in the observation group was significantly shorter than that in the control group(P<0.05).The total incidence of adverse reactions in the observation group and the control group was 10%and 16%,respectively,with no statistically significant difference(P>0.05).Conclusion The combination of methotrexate and uterine pregnancy formula can effectively reduce the amount of bleeding during curettage in CSP patients,shorten the time forβ-HCG levels to return to normal and menstrual recovery time,and is worthy of clinical promotion and application.

关 键 词：妊娠 子宫动脉栓塞术 刮宫术 人绒毛膜促性腺激素 

分 类 号：R714.22[医药卫生—妇产科学]