摘要
目的探讨剖宫产后子宫瘢痕处妊娠(CSP)的治疗方案和效果。方法选取河南科技大学第一附属医院2014-01—2016-12间收治的106例CSP患者。根据不同治疗方案分为3组:甲组(33例)采用MTX肌注+宫腔镜手术,乙组(38例)采用胚囊破坏联合MTX宫腔内注射+宫腔镜手术,丙组采用UAE+宫腔镜手术。比较3组疗效和不良反应。结果 (1)3组β-HCG恢复时间比较差异无统计学意义(P>0.05)。(2)术前治疗间隔时间及住院时间,甲组多于乙组和丙组,乙组多于丙组;阴道流血时间及月经恢复时间,甲组多于乙组和丙组;住院费用甲组和乙组均少于丙组;治疗成功率乙组和丙组均高于甲组;不良反应率乙组少于甲组和丙组。以上差异均有统计学意义(P<0.05)。结论对于CSP患者推荐胚囊破坏联合MTX宫腔内注射或UAE法治疗,然后行宫腔镜手术。前者兼顾疗效和安全性,同时对硬件要求低,可减轻患者经济负担,适合在基层医院开展。
Objective To analyze the three methods in the treatment of cesarean scar pregnancy retrospectively,investigating the treatment options and clinical practice of CSP.Methods Cesarean scar cases in our hospital were selected from January 2014 to December 2016.All 106 patients were divided into three groups.Group A were treated with MTX intramuscular injection treatment,Group B was treated with embryo sac destruction combined with MTX intrauterine injection and Group C was treated with Uterine artery embolization plus hysteroscopy.The clinical efficacy and adverse reactions of the three groups were observed.Results (1)There was no significant difference between the 3 groups in the recovery time of beta-HCG(P>0.05).(2)Group A treatment interval before surgery and the average hospitalization time is more than group B and group C,group B than group C;the time of vaginal bleeding and menstruation recovery time of group A is more than group B and group C;the average hospitalization expenses of group A and group B were less than group C;the success rate of treatment in group B and group C were higher than that of group A;the rate of adverse reactions in group B is less than group A and group C.The above differences were statistically significant(P<0.05).Conclusion The combination of embryo sac destruction and MTX intrauterine injection is effective and safe in the treatment of CSP.It can reduce the financial burden of patients and is suitable for primary hospitals.
作者
谢焕
王焱
Xie huan;Wang yan(The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology,Luoyang 471003,China;Xihua County People's Hospital,Xihua,Henan 466600,China)
出处
《河南外科学杂志》
2018年第2期41-44,共4页
Henan Journal of Surgery
基金
国家卫计委医药卫生科技发展研究课题(W2016CWHNB15)
关键词
瘢痕妊娠
胚囊破坏
MTX
子宫动脉栓塞
剖宫产
Scar pregnancy
Embryo sac destruction
MTX
Uterine artery embolization
Cesarean section
