子宫切口妊娠临床治疗分析

Analysis of clinical treatment for cesarean scar pregnancy

目的探究剖宫产术后子宫切口妊娠的临床治疗方法。方法 36例子宫切口妊娠患者按照随机原则分为观察组与对照组,每组18例。对照组采用甲氨蝶呤注射液肌内注射,观察组在阴道超声的辅助下直接向孕囊内注射甲氨蝶呤注射液稀释液。两组患者均配合早晚口服米非司酮片。比较两组患者的治疗效果和血β-人绒毛膜促性腺激素(β-HCG)转阴时间。结果观察组治疗总有效率为94.4%,明显高于对照组的66.7%,两组比较,差异具有统计学意义(P<0.05);观察组的血β-HCG转阴时间为(8.9±2.3)d,明显短于对照组的(14.2±3.1)d,两组比较,差异具有统计学意义(P<0.05)。结论在阴道超声的辅助下将甲氨蝶呤注射液稀释液直接注入孕囊可以提高治疗有效率,缩短血β-HCG转阴时间,值得临床推广。

Objective To investigate clinical treatment method for cesarean scar pregnancy after cesarean section. Methods A total of 36 patients with cesarean scar pregnancy were randomly divided into observation group and control group, with 18 cases in each group. The control group received intramuscular injection of methotrexate, and the observation group received transvaginal ultrasound-assisted direct injection of methotrexate diluent in gestational sac. Both groups received morning and night oral administration of mifepristone tablets. Comparison was made on curative effect and blood β-human chorionic gonadotropin（β-HCG） clearance time between the two groups. Results The observation group had obviously higher total effective rate as 94.4% than 66.7% in the control group, and the difference between the two groups had statistical significance（P〈0.05）. The observation group had blood β-HCG clearance time as（8.9±2.3） d, which was much shorter than（14.2±3.1） d in the control group, and their difference had statistical significance（P〈0.05）. Conclusion Direct injection of methotrexate diluent in gestational sac with assistance of transvaginal ultrasound can improve effectiveness of treatment and shorten bloodβ-HCG clearance time, and this method is worth clinical promotion.