摘要
目的探讨介入联合宫腔镜电切治疗剖宫产切口疤痕处妊娠的临床效果。方法选取2010年6月至2012年5月剖宫产切口疤痕处妊娠孕妇86例。按照介入治疗药物和栓塞物不同分成四组,A组21例,子宫双侧动脉灌注甲氨喋呤+明胶海绵栓塞;B组22例,子宫双侧动脉灌注米非司酮+明胶海绵栓塞;C组18例,子宫双侧动脉灌注甲氨喋呤+聚乙烯醇栓塞;D组25例,子宫双侧动脉灌注米非司酮+聚乙烯醇栓塞。比较四组β-HCG至对数下降时间(d)、电切时间(min)、阴道出血量(mL)、平均住院时间(d)和β-HCG转阴时间(d),以及比较四组盗汗、体重下降、体温升高、子宫疼痛和阴道出血发生率。结果 A组和C组β-HCG至对数下降时间和β-HCG转阴时间显著低于B组和D组(P均<0.05)。A组和B组电切时间、阴道出血量和平均住院时间均显著低于C组和D组(P<0.05)。A组盗汗、子宫疼痛发生率均显著低于B组、C组和D组(P<0.05),B组、C组和D组上述指标比较差异均无统计学(P<0.05)。结论子宫双侧动脉灌注甲氨喋呤并使用明胶海绵栓塞加入治疗后,再行宫腔镜电切治疗剖宫产切口疤痕处妊娠效果显著,副作用小,可在临床推广应用。
Objective To explore the clinical efficacy of interventional treatment combined with hysteroscopic electric resection for cesarean scar pregnancy.Methods Eighty-six patients with cesarean scar pregnancy,who received interventional treatment and hysteroscopic electric resection from June 2010 to May 2012,were randomly divided into four groups：group A （21 cases,uterine bilateral arterial infusion methotrexate＋gelatin sponge embolization）,group B （22 cases,bilateral uterine artery perfusion of mifepristone＋gelatin sponge embolization）,group C （18 cases,bilateral uterine artery perfusion of methotrexate＋polyvinyl alcohol embolization）,group D （25 cases,the uterus bilateral arterial perfusion of mifepristone＋polyvinyl alcohol embolization）.Comparison was made between the four groups in β-HCG to decline in the number of time （d）,electric cutting time （min）,the amount of vaginal bleeding （mL）,the average hospitalization time （d） andβ-HCG clearance time （d）,sweating,weight loss,increased body temperature,the incidence of vaginal bleeding,uterine pain.Results In group A and group C,β-HCG to decline in the number of time and β-HCG clearance time was significantly lower than those of group B and group D （P＜0.05）.The electric cutting time,the amount of vaginal bleeding and the average hospitalization time in group A and group B was significantly lower than those in group C and group D （P＜0.05）.In group A,night sweats,incidence of uterine pain was significantly lower than those in group B,group C and group D （P＜0.05）,which showed no statistical difference between group B,group C and group D （P＜0.05）.Conclusion Uterine artery perfusion with Methotrexate and gelatin sponge embolization,and hysteroscopic treatment have good effect for cesarean scar pregnancy,with small side effects,which can be promoted in clinical application.
出处
《海南医学》
CAS
2013年第16期2388-2390,共3页
Hainan Medical Journal
