甲氨蝶呤不同给药途径联合宫腔镜治疗子宫切口瘢痕妊娠患者的临床疗效观察

Clinical efficacy observation of Methotrexate of different administration routes combined with hysteroscopy in treatment of cesarean scar pregnancy

目的:观察甲氨蝶呤不同给药途径联合宫腔镜治疗子宫切口瘢痕妊娠患者的临床疗效。方法:剖宫产后子宫切口瘢痕妊娠的患者50例按照完全随机的方法分成A组和B组,每组各25例。A组患者给予甲氨蝶呤肌肉注射联合宫腔镜治疗;B组患者给予甲氨蝶呤妊娠囊注射联合宫腔镜治疗,对比两组患者的治疗效果。结果:A组患者血HCG值下降至1 000 u/L的时间、宫腔镜手术操作时间、住院时间及月经恢复正常时间均长于B组,术中出血量甲氨蝶呤用量明显多于B组,且术后并发症发生率高于B组,其差异均具有统计学意义(P<0.05)。结论:对于剖宫产后子宫切口瘢痕妊娠患者采用甲氨蝶呤妊娠囊注射联合宫腔镜治疗效果优于甲氨蝶呤肌肉注射联合宫腔镜治疗。

Objective： To investigate clinical efficacy of Methotrexate of different administration routes combined with hysteroscopy in treatment of cesarean scar pregnancy. Methods： 50 cases with cesarean scar pregnancy were divided into group A and group B with 25 cases in each group according to a completely random method. The patients in group A were given Methotrexate through intramuscular injection combined with hysteroscopy treatment,while those in group B group received Methotrexate through pregnancy sac injection combined with hysteroscopy treatment. The treatment effects of the two groups were compared. Results： The time for blood HCG value decreasing to 1000 u / L,hysteroscopic operation time,hospitalization time and menstrual recovery time of group A were longer than those of group B; intraoperative bleeding volume and Methotrexate dosage were significantly higher than those of group B; the complication rates were higher than those of group B,and all the differences were statistically significant（ P〈0. 05）. Conclusions：For the patients with cesarean scar pregnancy,Methotrexate through pregnancy sac injection combined with hysteroscopy treatment has better effects than Methotrexate through intramuscular injection combined with hysteroscopy treatment.