摘要
目的探讨比较单纯肌肉注射甲氨蝶呤、胚囊绞杀+注射甲氨蝶呤以及子宫动脉化学疗法(化疗)栓塞术3种方法治疗后进行清宫术治疗剖宫产瘢痕部位妊娠(CSP)的临床疗效。方法回顾性分析2009年1月-2013年12月住院的208例CSP患者治疗前后的临床资料,分为3组:A组72例,采用单纯肌肉注射甲氨蝶呤,B组70例,采用胚囊绞杀+注射甲氨蝶呤,C组66例,采用子宫动脉化疗栓塞术。比较3组患者术前治疗时间间隔、住院时间、清宫术中出血、血β-人绒毛膜促性腺激素(血β-HCG)下降至正常所需时间、住院费用、转经时间的差异。结果进行C组患者术后清宫的术前治疗时间间隔、住院时间、清宫术中出血、血β-HCG下降至正常时间、转经时间,均优于A组、B组,差异有统计学意义(P<0.05);3组住院费用差异无统计学意义(P>0.05)。结论子宫动脉化疗栓塞术治疗CSP,具有住院时间短、大出血风险低、患者生育功能易保留、安全、疗效确切的优点,值得临床推广应用。
Objective To compare the curative effect of three therapeutic strategies for cesarean scar pregnancy （CSP）. Methods Between January 2009 and December 2013, 208 patients with CSP underwent intramuscular methotrexate alone （group A, n=72）, transvaginal ultrasound monitoring after embryo sac strangulation after injection of methotrexate （group B, n=70） and uterine arterial chemoembolization therapy monitoring after hysteroscopy surgery （group C, n=66）. We studied their clinical data retrospectively. The preoperative treatment interval, the hospitalization days, intraoperative bleeding, time of blood I3-HCG to normal level and hospitalization costs were compared between the groups. Results The preoperative treatment interval, hospitalization days, intraoperative bleeding, and time of blood β-HCG to normal level of group C were significantly better than those of group A and B （P〈 0.05）, while the hospitalization cost of the three groups were not statistically signficant （P 〉 0.05）. Conclusion As a treatment for CSP, uterine artery chemoembolization is a safe and effective method, and it has the advantages of short hospitalization time, less intraoperative bleeding and high fertility preservation. It is worth application in clinical medicine.
出处
《华西医学》
CAS
2015年第5期895-898,共4页
West China Medical Journal
关键词
剖宫产瘢痕部位妊娠
子宫动脉化学疗法栓塞术
绞杀胚囊
甲氨喋呤
Cesarean scar pregnancy
Uterine artery chemotherapy
Strangulation embryo sac under ultrasoundmonitoring
Methotrexate
