摘要
目的:回顾性地评价氨甲喋呤(MTX)全身化疗、分别以聚乙烯醇颗粒和明胶海绵颗粒为栓塞剂经导管子宫动脉化疗栓塞治疗瘢痕妊娠的有效性与安全性。方法:44例瘢痕妊娠患者根据治疗方法的不同分为3组:A组13例,经静脉MTX全身化疗;B组15例,以明胶海绵颗粒为栓塞剂行子宫动脉MTX化疗栓塞术;C组16例,以聚乙烯醇颗粒为栓塞剂行子宫动脉MTX化疗栓塞术。3组治疗后均行刮宫术。以刮宫时的出血量、治疗成功率、子宫切除率、住院天数和人体绒毛膜促性腺激素(-βhCG)恢复时间作为评估治疗效果的参数。结果:与A组相比,B组和C组刮宫时的出血量明显减少(P<0.001),-βhCG恢复时间明显缩短(P<0.001),住院天数明显减少(P<0.01)。C组的疗效优于B组(P<0.05)。结论:以聚乙烯醇颗粒为栓塞剂经导管动脉化疗栓塞治疗瘢痕妊娠的有效率明显高于MTX化疗组和明胶海绵颗粒组。
Objective：The purpose of study was to retrospectively evaluate the efficacy and safety of systemic methotrexate （MTX） treatment versus transcatheter arteral chemoembolization （TACE） using polyvinyl alcohol （PVA） or gelatin sponge particles in terminating cesarean scar pregnancy （CSP）. Methods： Forty-four Patients with CSP were retrospectively classified imo three groups： in Group A, 13 patients receiving intravenous infusion of MTX; in Group B, 15 patients receiving TACE with MTX and gelatin sponge particles and in Group C, 16 patients receiving TACE using MTX and PVA particles. All groups were followed by suctional curettage. Bleeding, success rates, hysterectomy, the length of hospital stay and time for resolution of serum β-human chorionic gonadotropin （fl-hCG） were used as outcome endpoints. Results： Bleeding volume in group A were remarkblely less than that in group B and group C, （Group B C versus A, P〈 0. 001）. The mean time for resolution of β-hCG and the length of hospital stay in Group A was longer than that in group B and group C （Group B ＆- C versus A, P d0.01）. Furthermore, Group C had a higher success relative to group B （100% vs 66.7%, P 〈0. 05）. Conclusion： TACE using PVA is more effective in terminating CSP compared with systemic MTX and gelatin sponge particles.
出处
《医学影像学杂志》
2011年第8期1235-1239,共5页
Journal of Medical Imaging
关键词
氨甲喋呤
瘢痕妊娠
子宫动脉化疗栓塞
聚乙烯醇颗粒
明胶海绵颗粒
Methotrexate Cesarean scar pregnancy Transcatheter arteral chemoembolization Polyvinyl alcohol parti-cles~ Gelatin sponge particles
