甲氨蝶呤联合宫腔镜手术治疗剖宫产术后子宫瘢痕妊娠的疗效评价  

Efficacy evaluation of methotrexate combined with hysteroscopic surgery in the treatment of uterine scar pregnancy after cesarean section

作　　者：魏鑫 邢东升 古立红 郑杰 WEI Xin;XING Dong-sheng;GU Li-hong(Liaoyang Third People's Hospital,Liaoyang 111000,China)

机构地区：[1]辽阳市第三人民医院,111000 [2]辽阳市中心医院,111000

出　　处：《中国实用医药》2025年第4期118-120,共3页China Practical Medicine

摘　　要：目的探究甲氨蝶呤联合宫腔镜手术治疗剖宫产术后子宫瘢痕妊娠的疗效。方法60例剖宫产术后子宫瘢痕妊娠患者,采用随机数字表分为对照组和试验组,各30例。对照组给予甲氨蝶呤联合清宫术治疗,试验组给予甲氨蝶呤联合宫腔镜手术治疗。比较两组患者临床疗效及临床指标[术中出血总量、血清人绒毛膜促性腺激素(β-HCG)降至正常时间、术后月经来潮时间、住院治疗总天数]。结果试验组患者治疗总有效率为93.33%,高于对照组的70.00%,组间差异显著(P<0.05)。试验组患者术中出血总量(28.54±12.96)ml明显少于对照组的(95.72±32.14)ml,血清β-HCG降至正常时间(18.79±3.60)d、术后月经来潮时间(38.14±4.43)d及住院治疗总天数(8.97±1.70)d均显著短于对照组的(36.56±5.41)、(52.38±6.05)、(13.75±3.52)d,组间差异显著(P<0.05)。结论甲氨蝶呤联合宫腔镜手术治疗剖宫产术后子宫瘢痕妊娠效果显著,能够减少术中出血量,加快患者的术后康复速度,值得推广应用。Objective To explore the efficacy of methotrexate combined with hysteroscopic surgery in the treatment of uterine scar pregnancy after cesarean section.Methods 60 patients with uterine scar pregnancy after cesarean section were divided into a control group and an experimental group according to random numerical table,with 30 cases in each group.The control group was treated with methotrexate combined with curettage,and the experimental group was treated with methotrexate combined with hysteroscopic surgery.Comparison was made on clinical efficacy,clinical indicators[total amount of intraoperative blood loss,the time to normalization of serumβ-human chorionic gonadotropin(β-HCG),the time of postoperative menstruation,and the total length of hospital stay]between the two groups.Results The total effective rate of the experimental group was 93.33%,which was higher than 70.00%of the control group,and the difference between groups was significant(P<0.05).The the experimental group had significantly lower total amount of intraoperative blood loss of(28.54±12.96)ml than(95.72±32.14)ml in the control group;the time to normalization of serumβ-HCG,time of postoperative menstruation and total length of hospital stay were(18.79±3.60),(38.14±4.43)and(8.97±1.70)d in the experimental group,which were significantly shorter than(36.56±5.41),(52.38±6.05)and(13.75±3.52)d in the control group;the difference between groups was significant(P<0.05).Conclusion Methotrexate combined with hysteroscopic surgery has significant effect in the treatment of uterine scar pregnancy after cesarean section,which can reduce the intraoperative blood loss and accelerate the postoperative recovery of patients.It is worthy of promotion.

关 键 词：甲氨蝶呤 宫腔镜手术 剖宫产术后子宫瘢痕妊娠 

分 类 号：R71[医药卫生—妇产科学]