宫腔镜联合甲氨蝶呤及米非司酮对子宫切口妊娠患者的疗效及并发症

Efficacy and complications of hysteroscopy combined with methotrexate and mifepristone in the treatment of uterine incision pregnancy

目的观察宫腔镜联合甲氨蝶呤(Methotrexate,MTX)及米非司酮对子宫切口妊娠患者的疗效及对并发症的影响。方法选取2015年1月至2016年1月在我院接受治疗的子宫切口妊娠患者84例作为研究对象,按照治疗方法的不同将患者分为观察组与对照组。其中观察组在同时应用甲氨蝶呤及米非司酮治疗的情况下,实施宫腔镜电切术,对照组则仅应用甲氨蝶呤和米非司酮进行保守治疗,观察并对比两组患者治疗效果以及并发症情况。结果观察组患者β-人绒毛膜促性腺激素下降至正常的时间、包块消失时间较对照组缩短,差异有统计学意义(P<0.05)。观察组患者的终止妊娠率显著高于对照组,住院时间观察组显著低于对照组,差异有统计学意义(P<0.05)。两组患者腹痛发生率比较差异无统计学意义(P>0.05),但观察组恶心呕吐、肝功能损害的发生率低于对照组,差异有统计学意义(P<0.05)。结论在药物治疗的基础上,联合应用宫腔镜电切术对子宫切口妊娠患者疗效显著,术后并发症较药物保守治疗减少,值得推广应用。

Objective To explore the efficacy and complications of hysteroscopy combined with methotrexate（methotrexate,MTX） and mifepristone in the treatment of uterine incision pregnancy.Methods Totally 84 cases of uterine incision pregnancy in our hospital from January 2015 to January 2016 were selected as the research objects,and the patients were divided into observation group and control group according to different treatment methods.Observation group was treated with methotrexate and mifepristone at the same time,and then the implementation of hysteroscopy was carried out.Control group was treated only with methotrexate and mifepristone for conservative treatment.The efficacy and complications of the two groups were compared.Results The time of beta human chorionic promote gonadal hormone decreased to normal and mass disappeared in observation group was shorter than that of control group（P〈0.05）.The rate of termination of pregnancy in observation group was higher than that of control group（P〈0.05） with shorter hospitalization time（P〈0.05）.There was no significant difference in the incidence of abdominal pain between the two groups（P〉0.05）,but the occurrences of nausea,vomiting and liver function damage in observation group were significantly lower than those of control group（P〈0.05）.Conclusion Drug treatment combined with hysteroscopy has significant effects in the treatment of uterine incision pregnancy with low incidence of postoperative complications,so it is worth promoting in the application.