米非司酮联合超声引导下孕囊内注射甲氨蝶呤及清宫术治疗子宫瘢痕妊娠的临床观察

Clinical Observation of Mifepristone Combined with Ultrasound Guided Intragestational Methotrexate Injection and Uterine Evacuation in the Treatment of Uterine Scar Pregnancy

目的探究米非司酮联合超声引导下孕囊内注射甲氨蝶呤及清宫术治疗子宫瘢痕妊娠的临床效果。方法随机从2019年3月-2021年1月治疗的子宫瘢痕妊娠孕妇中选取60例,根据治疗方法不同分两组,对照组给予米非司酮联合清宫术治疗,试验组给予非司酮联合超声引导下孕囊内注射甲氨蝶呤及清宫术治疗,比较治疗情况、安全性。结果试验组距清宫术时间、术后阴道流血时间、住院时间短于对照组,试验组术中出血量少于对照组,P<0.05;试验组β-hCG下降率大于对照组,β-hCG转阴时间早于对照组,P<0.05;试验组不良反应率低于对照组,P<0.05。结论米非司酮联合超声引导下孕囊内注射甲氨蝶呤及清宫术治疗子宫瘢痕妊娠效果理想,利于促进患者尽快恢复,安全性较高。

Objective To explore the clinical effect of mifepristone combined with ultrasound-guided intragestational methotrexate injection and uterine evacuation in the treatment of uterine scar pregnancy.Methods Randomly select 60 pregnant women with uterine scars treated in our hospital from March 2019 to January 2021,and divide them into 2 groups according to different treatment methods.Control group:mifepristone combined with uterine evacuation treatment,test group:Fepristone combined with ultrasound-guided injection of methotrexate into the gestational sac and uterine evacuation treatment,comparison of treatment conditions and safety.Results The experimental group′s time to evacuation,postoperative vaginal bleeding,and hospital stay were shorter than those of the control group.The intraoperative blood loss of the experimental group was less than that of the control group,P<0.05;the beta-hCG decline rate in the experimental group was greater than that of the control group.The time for hCG to become negative was earlier than that of the control group,P<0.05;the adverse reaction rate of the test group was lower than that of the control group,P<0.05.Conclusions Mifepristone combined with ultrasound-guided injection of methotrexate in the gestational sac and uterine evacuation are effective in the treatment of uterine scar pregnancy,which is beneficial to promote the patient′s recovery as soon as possible,and has high safety.