甲氨喋呤联合宫腔镜治疗内生型剖宫产瘢痕妊娠的临床效果

The clinical efficacy of methotrexate combined with hysteroscopy to treat endogenous cesarean scar pregnancy

目的:分析甲氨喋呤联合宫腔镜治疗内生型剖宫产瘢痕妊娠的临床疗效。方法:选择本院就诊的内生型瘢痕妊娠患者为研究对象72例,按照自愿选择的原则分成对照组及观察组,对照组(33例)应用甲氨蝶呤联合清宫术治疗,观察组(39例)应用甲氨蝶呤联合宫腔镜治疗,比较两组临床疗效及各指标之间的差异,分析观察组中病灶不同大小的临床疗效。结果:观察组的总有效率(97.4%)大于对照组(84.9%)(P=0.020),术中出血量、血β-hCG降至正常的时间、治疗后住院时间小于对照组(P=0.000、0.002、0.010)。观察组病灶直径≤2.5cm患者治疗的总有效率(100%)高于病灶直径>2.5cm患者总有效率(90.9%)(P=0.010)。结论:甲氨蝶呤联合宫腔镜对于内生型瘢痕妊娠,尤其是对于病灶直径≤2.5cm的病例有较好的疗效,值得临床探索应用。

Objective： To analyze the clinical efficacy of methotrexate combined with hysteroscopy to treat endogenous cesarean scar pregnancy. Methods： 72 patients with endogenous cesarean scar pregnancy were collected and divided into control group （33 cases） and observation group （a9 cases） according to voluntary selection of patients. The patients in control group were given methotrexate combined with curettage, and the patients in observation group were given methotrexate combined with hysteroscopy. The treatment difference and clinical efficacy were compared between the two groups. The clinical was analyzed among patients with different size of the lesions in observation group. Results： The rate of total effectiveness of patients in the observation group was 97.4 ~, which was significant greater than that of patients（84.9% ） in the control group（P=0.020）. The amount of bleeding, the time of 13-HCG returned to normal level, and hospitalization time of patients in observation group were less than those of patients in the control group（P =0.00,0.002,0.010）.In observation group, the rate of total effective of patients with diameter of the lesions≤2.5cm was 100%, which was greater than that（99.91%） of patients with diameter of the lesions 〉2.5cm （P=0.010）.Con- clusion： The methotrexate combined with hysteroscopy has better effectiveness for treating patients with endogenous cesarean scar pregnancy, especially for patient with diameter of lesions≤2.5cm, so it is worth to apply in the clinical practice.