摘要
目的比较三种治疗方法对剖宫产后子宫疤痕妊娠的治疗效果。方法选取2015年1月至2017年1月温州医科大学附属第三医院80例剖宫产术后子宫疤痕妊娠(CSP)患者为研究对象,分别采用妊娠病灶切除术+子宫疤痕修补术治疗(A组,29例)、子宫动脉栓塞术(UAE)和(或)超声监测下清宫术(B组,24例)、甲氨蝶呤(MTX)+超声监测下清宫术/+米非司酮药物治疗(C组,27例),比较3种治疗方法的疗效。结果与C组比较,A、B组患者的血β-hCG水平降至正常的时间(q_(A-C)=8.05,q_(B-C)=5.03)及住院时间(q_(A-C)=10.25,q_(B-C)=6.97)均明显降低,差异具有统计学意义(均P<0.05)。与C组比较,A、B组的治疗费用明显升高(q_(A-C)=12.05,q_(B-C)=9.80),而随访时间则明显降低(q_(A-C)=15.96,q_(B-C)=10.44),差异均具有统计学意义(均P<0.01)。经治疗后,所有患者均顺利出院。结论个体化治疗的原则适用于临床上对CSP患者的治疗。均完成UAE之后推迟施行或不行清宫术、MTX与米非司酮药物联用治疗CSP不仅临床疗效良好而且安全性高,对于妊娠病灶的及时切除可进一步使治疗周期缩短,效果明显。
Objective To compare the therapeutic effects of three treatments on cesarean scar pregnancy（CSP）.Methods Eighty patients with CSP were selected from January 2015 to January 2017 in Ruian People＇s Hospital.Pregnancy lesion excision combining uterine scar neoplasty（group A,29 cases）,uterine arterial embolism（UAE）and/or B ultrasonic guided curettage of uterine（group B,24 cases）,and MTX and B ultrasonic guided curettage of uterine with mifepristone（group C,27 cases）were adopted.Therapeutic efficacy of these three treatments was compared.Results Compared with group C,the time of bloodβ-hCG level in group A and group B decreasing to the normal level（qA-C=8.05,qB-C=5.03）and the time of hospitalization（qA-C=10.25,qB-C=6.97）was remarkably shorter with statistical significance（P〈0.05）.Compared with group C,the cost of treatment in group A and group B was significantly higher（qA-C=12.05,qB-C=9.80）but the follow-up time was significantly decreased（qA-C=15.96,qB-C=10.44）with significant differences（all P〈0.01）.After treatment,all patients were discharged.Conclusion Individual therapy is suitable for CSP.Treatment of putting off or without curettage of uterine after UAE as well as MTX and mifepristone for CSP obtains good clinical effect with safety.Timely excision of lesions helps to further shorten therapeutic course with obvious efficacy.
作者
陈凤丹
郑秀英
吕杰强
CHEN Feng-dan;ZHENG Xiu-ying;LYU Jie-qiang(Department of Gynecology and Obstetrics, Ruian People ＇ s Hospital, Zhej iang Ruian 325200, China;Department of Gynecology and Obstetrics, Affiliated Second Hospital of Wenzhou Medical University in Zhejiang province, Zhejiang Wenzhou 325027,Ch/na)
出处
《中国妇幼健康研究》
2018年第6期806-809,共4页
Chinese Journal of Woman and Child Health Research
关键词
剖宫产术后子宫疤痕妊娠
甲氨蝶呤
子宫动脉栓塞术
疗效
cesarean scar pregnancy （CSP）
methotrexate （MTX）
uterine artery embolization （UAE）
efficacy
