摘要
目的探析剖宫产术后子宫切口瘢痕处妊娠不同治疗方法效果。方法便利选取该院于2014年1月—2017年12月收治的90例剖宫产术后子宫切口瘢痕处妊娠患者,将其按照数字随机法分为观察组、对照1组、对照组2组,其中对照1组30例采用甲氨蝶呤+四氢叶酸+米非司酮治疗,对照2组30例采用B超下经腹或阴道穿刺术治疗,观察组30例采用甲氨蝶呤+子宫动脉栓塞术+清宫术治疗,对比3组患者治疗效果。结果观察组的治疗成功率93.3%高于对照组1组66.7%、对照组2组63.3%,且观察组的阴道出血量、平均住院时间、HCG转阴时间均优于对照1组、对照组2组,此外,观察组的不良反应发生率13.3%低于对照1组46.7%、对照组2组33.3%,对比均差异有统计学意义(P<0.05)。结论剖宫产术后子宫切口瘢痕处妊娠患者应用甲氨蝶呤+子宫动脉栓塞术+清宫术治疗效果显著,可提高治疗成功率,降低不良反应情况,值得推广。
Objective To explore the effect of different treatments for uterine scars after cesarean section. Methods A total of 90 patients with uterine incision scars who were treated in the hospital from January 2014 to December 2017 were convenient selected and divided into observation group, control group 1, and control group 2 according to a random number method. Among them, 30 patients in the control group 1 were treated with methotrexate ＋ tetrahydrofolate ＋ mifepristone; 30 patients in the control group 2 were treated with B-ultrasound or transvaginal puncture; 30 patients in the observation group were treated with methotrexate ＋ Uterine arterial embolization ＋ uterine curettage, compared the treatment effect of the two groups of patients. Results The treatment success rate of the observation group was 93.3% higher than that of the control group 1 66.7% and that of the control group 2 63.3%, and the observation group had better vaginal bleeding, average length of hospital stay, and HCG negative time than the control group 1 and control group 2, in addition, the incidence of adverse reactions in the observation group was 13.3% lower than that of the control group 1（46.7%） and that of the control group 2（33.3%）. The difference was statistically significant（P 0.05）. Conclusion The use of methotrexate ＋ uterine artery embolization ＋ resection of uterine cervix in patients with uterine incision scars after cesarean section is effective. It can improve the success rate of treatment and reduce adverse reactions. It is worthy of promotion.
作者
王奕文
WANG Yi-wen(Department of Obstetrics and Gynecology,First Hospital of Quanzhou,Fujian Medical University,Jinjiang,Fujian Province,362000 China)
出处
《中外医疗》
2018年第22期52-53,59,共3页
China & Foreign Medical Treatment
关键词
剖宫产
子宫切口瘢痕处妊娠
甲氨蝶呤
子宫动脉栓塞术
清宫术
Cesarean section
Uterine incision sear pregnancy
Methotrexate
Uterine artery embolization
Curettage
