经阴道超声介入引导局部注射甲氨蝶呤治疗子宫瘢痕妊娠的临床疗效与安全性分析

Curative effect and safety analysis of transvaginal ultrasound interventional guide local injections of methotrexate in the treatment of uterine scar pregnancy

目的:探究与分析经阴道介入引导局部注射甲氨蝶呤治疗子宫瘢痕妊娠的临床疗效与安全性。方法:选取我院自2013年1月至2015年1月收治的60例子宫瘢痕妊娠患者,采取随机数字表法分为单次肌肉注射组与经阴道超声介入组,每组各30例,对比两组患者的临床疗效及血HCG下降至正常水平的时间及附件包块完全吸收的时间。结果:单次肌肉注射组治愈率为46.67%,修正后治愈率为53.33%,经阴道超声介入组的治愈率为90.00%,修正后治愈率为93.33%,组间相比均具有显著差异(P<0.05)。单次肌肉注射组血HCG下降至正常水平时间为(30.25±4.68)d、附件包块完全吸收时间为(48.78±7.05)d,经阴道超声介入组血HCG下降至正常水平时间为(16.56±3.57)d、附件包块完全吸收时间为(40.21±5.67)d,组间相比均具有显著差异(P<0.05)。结论:经阴道介入引导局部注射甲氨蝶呤治疗子宫瘢痕妊娠的临床疗效显著,可显著缩短血HCG下降至正常水平及附件包块完全吸收的时间,预后较为良好,安全性较高,值得广泛推广与应用。

Objectives： To explore and analyze the clinical curative effect and safety of transvaginal ultrasound interventional guide local injections of methotrexate in the treatment of uterine scar pregnancy. Methods： 60 patients with uterine scar pregnancy in our hospital from January 2013 to January 2015 were selected and randomlydivided into only muscle injection group and transvaginal ultrasound intervention group,30 cases in each group. The clinical curative effect,the time of blood- HCG dropped to normal level and time of accessory bag piece completely absorbed of the two groups were compared. Results： The cure rate of only muscle injection group was 46. 67%;revised cure rate was 53. 33%. The cure rate of transvaginal ultrasound intervention group was 90. 00%; revised cure rate was 93. 33%. The difference between groups was significant（ χ2= 5. 98,P〈0. 05; χ2= 6. 21,P〈0. 05）. The time of blood- HCG dropped to normal level and time of accessory bag piece completely absorbed in only muscle injection group were（ 30. 25 ± 4. 68） d and（ 48. 78 ± 7. 05） d,the time of blood- HCG dropped to normal level and time of accessory bag piece completely absorbed in transvaginal ultrasound intervention group were（ 16. 56 ± 3. 57） d and（ 40. 21 ± 5. 67） d. The difference between groups was significant（ t = 3. 45,P〈0. 05,t = 0. 05,P〈0. 05）. Conclusion： Transvaginal intervention guide local injections of methotrexate in the treatment of uterine scar pregnancy has significant curative effect and can significantly shorten the time of blood HCG dropped to normal levels and accessory bag piece fully absorbed. The prognosis is relatively good,with high security,which is worth popularization and application widely.