子宫下段瘢痕妊娠保守治疗24例临床分析

Clinical Analysis of Treatment in Lower Uterine Segment Cesarean Section Scarpregnancy

目的：探讨药物保守治疗剖宫产术后子宫下段瘢痕部位妊娠的保守治疗。方法：选择2004年4月-2013年2月收入我院剖宫产手术瘢痕妊娠患者24例，采用米非司酮联合甲氨喋呤（ MTX）药物治疗，检测β－HCG下降水平、脐动脉阻力指数。结果：治疗前脐动脉阻力指数（RI）为0．58±0．18，治疗5天后为（0．46±0．13），治疗7天后RI升高为（0．85±0．18），治疗前后相比，差异有统计学意义。治疗前血β－hCG 为4157 U／I （213-8927 U／L ）；治疗5天后血β－hCG升高至6518．2 U／L （298-10093U／L）；治疗7天后血β－hCG下降至2730．7U／L（159-5144U／L），治疗前后差异有统计学意义。结论：米非司酮联合甲氨喋呤药物治疗安全有效。

Objective：To investigate the clinical efficacy of 24 cases in lower uterine segment cesarean section scarpregnancy .Meth-ods：24 cases in lower uterine segment cesarean section scarpregnancy were treated by mifepristone and methotrexate in our hospital be -tween April 2004 and February 2013.β-HCG levels and RI were detected in 24 cases.Results：Umbilical artery resistance index （ RI） had risen from 0.58 ±0.18 to 0.85 ±0.18 after 7 days, the difference was statistically significant;serumβ-hCG had risen from 4157U/I（213-8927U/L）to 2730.7U/L（159-5144U/L）after 7 days, there was significant difference before and after treatment .Conclusion：Mifepristone combined with methotrexate therapy is safe and effective .