摘要
目的分析甲氨蝶呤联合宫腔镜手术治疗剖宫产术后子宫瘢痕妊娠的疗效。方法方便选取该院妇产科收治的剖宫产术后子宫瘢痕妊娠患者60例进行观察,患者在2017年1月-2019年10月期间被收治入院,并依据奇偶数随机标号结果分组,其中对照组采用甲氨蝶呤+清宫手术治疗,观察组采用甲氨蝶呤+宫腔镜手术治疗,对比两组患者的疗效、临床指标。结果观察组患者的治疗总有效率达到了96.55%(28例),对照组为70.00%(21例),其中3例患者中转宫腔镜手术,1例被迫切除子宫,两组数据差异有统计学意义(χ^2=5.454,P<0.05);观察组术中出血量为(36.38±13.87)mL,血清β-HCG降至正常时间为(21.12±5.28)d,住院时间为(13.62±3.18)d,月经来潮时间为(38.72±3.25)d,各项数据较之对照组差异有统计学意义(t=16.126、14.043、11.116、12.895,P<0.05)。结论甲氨蝶呤联合宫腔镜手术治疗剖宫产术后子宫瘢痕妊娠具有较高的安全性,而且疗效显著,手术损伤较小,术后恢复更快。
Objective To analyze the effect of methotrexate combined with hysteroscopy on uterine scar pregnancy after cesarean section.Methods Sixty patients with uterine scar after cesarean section admitted to our department of obstetrics and gynecology were conveniently selected.The patients were admitted between January 2017 and October 2019.They were grouped according to the results of odd and even random labeling,of which,the control group was treated with methotrexate+hysterectomy,and the observation group was treated with methotrexate+hysteroscopy.The efficacy,clinical indicators were compared between the two groups.Results The total effective rate of treatment in the observation group reached 96.55%(28 cases)and that in the control group was 70.00%(21 cases).Among them,3 patients were converted to hysteroscopy and 1 was forced to remove the uterus.The data difference between the two groups was significant(χ^2=5.454,P<0.05);the intraoperative blood loss in the observation group was(36.38±13.87)mL,the time for serumβ-HCG to fall to normal was(21.12±5.28)d,and the hospital stay was(13.62±3.18)d The menstrual tide time was(38.72±3.25)d,and the data were significantly different from the control group(t=16.126,14.043,11.116,12.895 P<0.05).Conclusion Methotrexate combined with hysteroscopy for uterine scar pregnancy after cesarean section has high safety,and it has significant curative effect,less surgical injury and faster postoperative recovery.
作者
张存虎
ZHANG Cun-hu(Department of Obstetrics and Gynecology,Yanggu County People's Hospital,Yanggu,Shandong Province,252300 China)
出处
《中外医疗》
2020年第12期4-6,共3页
China & Foreign Medical Treatment
关键词
甲氨蝶呤
宫腔镜手术
剖宫产术后子宫瘢痕妊娠
临床疗效
安全性
Methotrexate
Hysteroscopic surgery
Uterine scar pregnancy after cesarean section
Clinical efficacy
Safety
