超声引导下经阴道经宫颈穿刺注射甲氨蝶呤对子宫切口妊娠的临床疗效

Clinical effect of transvaginal methotrexate injection guided by ultrasound in the treatment of uterine incision pregnancy

目的:探讨超声引导下经阴道经宫颈穿刺注射甲氨蝶呤治疗子宫切口妊娠的疗效。方法:回顾性分析20例肌肉注射甲氨蝶呤(对照组)及20例超声引导下经阴道经宫颈孕囊穿刺抽液并注射甲氨蝶呤(观察组)治疗子宫切口妊娠的临床资料,观察治疗效果、副作用、住院时间等,并对比分析疗效。结果:观察组甲氨蝶呤总用量、住院时间、β-hCG恢复正常时间、阴道出血、转氨酶增高、白细胞下降、治疗成功率、不良反应发生的情况明显优于对照组。结论:超声引导下经阴道经宫颈孕囊穿刺抽液并注射甲氨蝶呤治疗子宫切口妊娠安全性好,成功率高,副作用小;具有操作简便、疗效确切等优点,值得临床推广。

Objective:To investigate the efficacy of transvaginal and transcervical methotrexate(MTX)in-jection guided by ultrasound in the treatment of cesarean scar pregnancy.Methods:Of the 40 cases of incisional pregnancy,20 cases received intramuscular MTX injection,while antother 20 cases re-ceived ultrasound-guided transvaginal and transcervical pregnancy sac puncture plus MTX injection.The side effect,length of stay,and the curative effect were recorded and compared.Results:Accord-ing to the results of the total dosage of MTX,length of stay,β-hCG recovery time,vaginal bleeding,liver function,leukocyte count,treatment success rate and adverse reactions in the ultrasound-guided group were significantly better than those in the intramuscular injection group.Conclusion:Ultrasound-guided transvaginal and transcervical puncture and extraction of pregnancy sac combined with injec-tion of methotrexate in the treatment of uterine incision pregnancy have good safety,high success rate and few side reactions.It also has the advantages of simple operation,definite curative effect and reli-ability.