引用本文:姬梦鸽,孟跃进,顾晓荔,符元元.药物联合宫腔镜治疗剖宫产瘢痕部位妊娠的临床疗效分析[J].中国临床新医学,2019,12(3):268-271.
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药物联合宫腔镜治疗剖宫产瘢痕部位妊娠的临床疗效分析
姬梦鸽,孟跃进,顾晓荔,符元元
450014 河南,郑州大学第二附属医院妇产科
摘要:
[摘要] 目的 探讨先用甲氨蝶呤(MTX)联合米非司酮于前期干预后再行宫腔镜下清宫术治疗剖宫产瘢痕部位妊娠(CSP)的临床疗效。方法 回顾性分析2016-12~2017-12于该院住院治疗CSP患者84例的病例资料,按照不同治疗方式分为观察组和对照组各42例。观察组采用MTX+米非司酮治疗后行宫腔镜下清除术,对照组直接行宫腔镜下清除术;比较两组患者治疗过程中手术时间、出血量、住院天数、血β-人绒毛膜促性腺激素(β-HCG)恢复正常时间及术后并发症发生率。结果 观察组手术时间、术中出血量、血β-HCG恢复正常时间均短于对照组,差异有统计学意义(P<0.01),但观察组住院时间长于对照组,差异有统计学意义(P<0.01),两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论 MTX+米非司酮前期干预后再行宫腔镜下清除术治疗CSP可以缩短手术时间,减少术中出血量,预后良好,值得临床推广。
关键词:  剖宫产瘢痕部位妊娠  宫腔镜  甲氨蝶呤  米非司酮
DOI:10.3969/j.issn.1674-3806.2019.03.07
分类号:R 714.2
基金项目:河南省医学科技攻关项目(编号:201204037)
Clinical analysis of drugs combined with hysteroscopy in treatment of cesarean scar pregnancy
JI Meng-ge, MENG Yue-jin, GU Xiao-li, et al.
Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Zhengzhou University, Henan 450014, China
Abstract:
[Abstract] Objective To investigate the clinical efficacy of hysteroscopic uterine curettage for cesarean section scar pregnancy(CSP) after pre-intervention of methotrexate(MTX) and mifepristone. Methods The CSP patients hospitalized in our hospital from December 2016 to December 2017 were divided into two groups according to different treatment methods. The observation group(n=42) received hysteroscopic uterine curettage after treatment with MTX+mifepristone, and the control group(n=42) received hysteroscopic uterine curettage alone. The operation time, the amount of bleeding, the length of hospital stay, the time of blood β-HCG recovery to normal and the incidence of postoperative complications were compared between the two groups. Results The intraoperative time, the time of blood β-HCG recovery to normal and the intraoperative blood loss in the observation group were significantly shorter or less than those in the control group(P<0.01). The length of hospital stay in the observation group was significantly longer than that in the control group(P<0.01). There was no significant differences in the incidence of postoperative complications between the two groups(P>0.05). Conclusion Pre-intervention of MTX+mifepristone can shorten the operation time, reduce the amount of intraoperative blood loss in the treatment of CSP using hysteroscopic uterine curettage.
Key words:  Cesarean scar pregnancy  Hysteroscopy  Methotrexate  Mifepristone