MTX介入或全身用药联合中药口服治疗剖宫产瘢痕妊娠的优越性探讨

Discussion on Advantages of MTX Intervention or Systemic Administration Combined with Oral Administration of TCM for Cesarean Scar Pregnancy

目的:探讨MTX肌注或子宫动脉栓塞联合中药口服治疗剖宫产瘢痕妊娠的临床应用价值。方法:将72例剖宫产瘢痕妊娠患者分为治疗组和对照组,治疗组再分为A、B两组,A组采取MTX肌注联合自拟消妊祛瘀汤口服,B组经子宫动脉MTX化疗栓塞加消妊祛瘀汤口服;对照组则分为C、D两组,C组单纯MTX肌注,D组经子宫动脉MTX化疗栓塞。观察各组患者治疗效果及不良反应情况。结果:各组治愈率:A组91.67%,B组96.43%,治疗组75.00%;C组70.00%,D组90.91%,对照组84.38%,治疗组与对照组比较有显著性差异(P<0.05),且治疗组在血HCG下降速度、住院时间、转经时间等方面优于对照组,不良反应发生率低。结论:MTX介入或全身用药联合中药口服治疗剖宫产瘢痕妊娠安全、疗效确切,结合中、西医治疗的优势,避免了创伤性手术,值得临床广泛推广应用。

Objective： To explore the clinical effect of MTX intramuscular injection or uterine artery embolization combined with oral administration of traditional chinese medicine for cesarean scar pregnancy. Methods： 72 Patients with cesarean scar pregnancy were divided into two groups, treatment group and control group. The treatment group was subdivided into group A and group B, group A was applied to MTX intramuscular injection combined with purpose-made pregnancy-easing stasis-removing decoction, group B was given uterine artery MTX chemoembolization plus purpose-made pregnancy-easing stasis-removing decoction. The control group was subdivided into group C and group D, group C was treated with MTX intramuscular injection only, while group D was applied to uterine artery MTX chemoembolization. Clinical effect and adverse reactions of patients in each group were observed and analyzed. Results： Cure rate of each group varies： group A（91.67%）, group B（96.43%）, the treatment group（95.00%）, group C（70.00%）, group D（90.91%）, the control group（84.38%）. Significant difference of cure rate between treatment group and control group was observed（P0.05）. Compared with patients in control group, patients in treatment group experienced shorter hospitalization, less adverse reactions and quicker recovery of blood HGG level and menstruation. Conclusion： MTX intramuscular injection or uterine artery embolization combined with oral administration of traditional chinese medicine for cesarean scar pregnancy has advantages of being safer, more accurate and effectual. The treatment avoids traumas from surgical operations by combining advantages of TCM and WM, and should be promoted and popularized in clinical use.