术前局部与全身予以甲氨蝶呤预处理对剖宫产瘢痕妊娠患者手术治疗效果的影响  

Effect of preoperative local and systemic pretreatment with methotrexate on the surgical treatment of cesarean scar pregnancy patients

作　　者：卢燕敏 黄玉平 黄娟平 Lu Yan-min;Huang Yu-ping;Huang Juan-ping(Department of Obstetrics and Gynecology,Nankang Xinhua Hospital,Ganzhou 341400,Jiangxi,China)

机构地区：[1]南康新华医院妇产科,江西赣州341400

出　　处：《四川生理科学杂志》2025年第1期216-218,共3页

摘　　要：目的:探究术前局部与全身予以甲氨蝶呤(MTX)预处理对剖宫产瘢痕妊娠(CSP)患者手术治疗效果的影响。方法:选取本院2020年5月至2023年8月期间收治的60例剖宫产瘢痕妊娠患者为研究对象,按照MTX预处理方式将患者分为肌注MTX组(n=30)与局部注射MTX组(n=30),对比两组治疗成功率、术中及术后指标(术中出血量、手术时间、术后住院时间)、血清人绒毛膜促性腺激素(β-HCG)水平,并统计术后不良反应发生情况。结果:局部注射MTX组治疗成功率为93.33%(28/30),较肌注MTX组73.33%(22/30)显著高(P<0.05);局部注射MTX组术中出血量低于肌注MTX组,手术时间、术后住院时间短于肌注MTX组(P<0.05);与术前相比较,两组患者术后血清β-HCG水平均下降(P<0.05),局部注射MTX组术后血清β-HCG水平较肌注MTX组更低(P<0.05);局部注射MTX组不良反应总发生率(33.33%)相较于肌注MTX组(10.00%)更低(P<0.05)。结论:术前局部予以MTX预处理能提高GSP患者手术治疗成功率,增强手术治疗效果,降低不良反应发生率。Objective:To investigate the effect of preoperative local and systemic methotrexate(MTX)pretreatment on the surgical treatment of cesarean scar pregnancy(CSP)patients.Methods:Sixty patients with cesarean scar pregnancy admitted to our hospital between May 2020 and August 2023 were selected as the study subjects.According to the MTX pre-treatment method,the patients were divided into a intramuscular injection MTX group(n=30)and a local injection MTX group(n=30).The success rate of treatment,intraoperative and postoperative indicators(intraoperative bleeding volume,surgical time,postoperative hospital stay),serum human chorionic gonadotropin(HCG),and serum were compared between the two groups(β-HCG) levels were measured,and the incidence of postoperative adverse reactions was recorded.Results:The success rate of local injection of MTX group was 93.33%(28/30),significantly higher than that of intramuscular injection of MTX group at 73.33%(22/30)(P<0.05);The intraoperative bleeding volume in the local injection MTX group was lower than that in the intramuscular injection MTX group,and the surgical time and postoperative hospital stay were shorter than those in the intramuscular injection MTX group(P<0.05);Compared to preoperative,the postoperative serum of both groups of patientsβ-HCG levels all decreased(P<0.05),and the postoperative serum of the MTX group was injected locallyβ-The HCG level was lower in the group receiving intramuscular injection of MTX(P<0.05);The total incidence of adverse reactions in the group receiving local injection of MTX(33.33%)was lower than that in the group receiving intramuscular injection of MTX(10.00%)(P<0.05).Conclusion:Preoperative local MTX pretreatment can improve the success rate of surgical treatment in GSP patients,enhance the effectiveness of surgical treatment,and reduce the incidence of adverse reactions.

关 键 词：剖宫产瘢痕妊娠 甲氨蝶呤 预处理 

分 类 号：R71[医药卫生—妇产科学]