单用甲氨蝶呤与联合子宫动脉栓塞术对剖宫产术后瘢痕子宫妊娠的疗效对照研究

Evaluation of Methotrexate alone and combined with uterine arterial embolization in the treatment of cesarean scar pregnancy after cesarean section

目的探讨单用甲氨蝶呤与联合子宫动脉栓塞术对剖宫产术后子宫瘢痕妊娠的疗效。方法选择本院2016年1月至2016年11月收治的42例剖宫产术后子宫瘢痕妊娠患者为研究对象,采用随机数表法将其分为观察组和对照组,每组各21例。对照组患者给予甲氨蝶呤治疗,观察组患者给予甲氨蝶呤联合子宫动脉栓塞术治疗。比较两组患者子宫内包块消失时间、血清β-人绒毛膜促性腺激素(β-human chorionic gonadotrophin,β-hCG)恢复正常时间、住院天数、疗效及不良反应发生情况。结果治疗后,观察组患者子宫内包块消失时间、血清β-hCG恢复正常时间及住院天数均显著短于对照组(P<0.05),治疗总有效率显著高于对照组(P<0.05),不良反应发生率显著低于对照组(P<0.05)。结论甲氨蝶呤联合子宫动脉栓塞术对剖宫产术后子宫瘢痕妊娠的疗效较单用甲氨蝶呤更显著,不良反应发生率低。

Objective To explore the efficacy of Methotrexate alone and combined with uterine arterial embolization in the treatment of cesarean scar pregnancy after cesarean section. Method 42 patients with cesarean scar pregnancy in our hospital from January 2016 to November 2016 were selected as the research objects, and they were divided into observation group and control group according to random number table method, 21 cases in each group. Control group patients were given Methotrexate therapy, observation group patients were treated with Methotrexate combined with uterine arterial embolization. Disappearance time of intrauterine mass, returned to normal time of β-human chorionic gonadotrophin （β-hCG）, hospital day, efficacy and occurrence of adverse reactions were compared between the two groups. Result After treatment, disappearance time of intrauterine mass, returned to normal time of β-hCG, hospital day of observation group were less than control group （P〈0.05）; the total effective rate was significantly higher than control group （P〈0.05）, the incidence rate of adverse reaction was significantly lower than control group （P〈0.05）. Conclusion Methotrexate combined with uterine arterial embolization in the treatment of cesarean scar pregnancy after cesarean section is more significant than Methotrexate, adverse reaction rate is low.