摘要
目的探讨腹腔镜联合甲氨蝶呤治疗剖宫产术后瘢痕处妊娠的疗效。方法选择186例剖宫产后瘢痕妊娠患者，根据随机数字表法将患者分为联合组和对照组，每组93例。联合组在对照组的基础上给予甲氨蝶呤，比较两组患者在术后3天、5天、10天时血β-HCG变化及恢复正常所需时间。比较两组随访12个月、24个月宫内妊娠及PEP发生情况。结果联合组在术后3天、5天、10天时血β-HCG明显低于对照组，差异有统计学意义，联合组术后血β-HCG水平恢复至正常所需时间明显短于对照组，差异有统计学意义；联合组随访术后12个月、24个月宫内妊娠发生率明显高于对照组，差异有统计学意义（P〈0．05）。结论腹腔镜手术联合甲氨蝶呤局部注射、术前术后口服米非司酮能有效促进剖宫产后瘢痕妊娠患者术后血β-HCG恢复正常，提高术后远期宫内妊娠发生率，安全可靠，值得临床推广应用。
Objective To investigate clinical curative effect of laparoscopy combined with methotrexate for cesarean scar pregnancy after cesarean section. Methods 186 patients with cesarean scar pregnancy were divided into combination group and control group with 93 cases in each group according to the random number table. Patients of combined group were given methotrexate on the basis of those of control group. Changes of serum β-HCG 3 days, 5 days, 10 days after operation and returning to normal time were compared between two groups. The occurrence of PEP and intrauterine pregnancy in followed up of 12 months, 24 months were compared between two groups. Results Serum β-HCG of combination group 3 days, 5 days, 10 days after operation were significantly lower than those of control group, with statistically significant differences （P〈0.05）. The time of serum β-HCG returning to normal after operation of combination group was significantly shorter than that of control group, with statistically significant difference （P〈0.05）. The incidence of intrauterine pregnancy of combination group in followed up of 12 months, 24 months were significantly higher than those of control group, with statistically significant differences （P〈0.05）. Conclusion Laparoscopic operation combined with methotrexate injecting locally, taking oral mifepristone can effectively promote serum β-HCG of patients with cesarean scar pregnancy after operation returning to normal, improve the incidence of long-term postoperative uterine pregnancy, safe and reliable, worthy of further clinical application.
出处
《国际医药卫生导报》
2016年第3期358-360,共3页
International Medicine and Health Guidance News
关键词
腹腔镜
甲氨蝶呤
妊娠
米非司酮
Laparoscopy
Methotrexate
Pregnancy
Mifepristone
