腹腔镜监护下吸宫术联合MTX、米非司酮治疗子宫瘢痕处妊娠的意义

Significance of laparoscopy combined with MTX and mifepristone in the treatment of uterine scar pregnancy

目的分析腹腔镜监护下吸宫术联合MTX、米非司酮治疗子宫瘢痕处妊娠的意义。方法选取2015年7月~2017年5月常山县人民医院收治的86例子宫瘢痕处妊娠患者为研究对象,随机分为对照组和实验组,每组43例。对照组进行MTX、米非司酮治疗,肌内注射50 mg/m^2甲安喋呤,米非司酮口服,每天3次。实验组患者进行腹腔镜监护下吸宫术联合MTX、米非司酮治疗。比较分析实验组与对照组患者住院时间、治愈率及阴道流血时间等临床指标。结果实验组组治疗成功率为100.0%显著高于对照组治疗成功率72.42%,差异具有统计学意义（P〈0.05）。实验组阴道流血时间为（20.87±6.54）d,显著短于对照组（34.20±10.89）d,差异具有统计学意义（P〈0.05）。实验组β-HCG下降到正常所需时间为（26.90±9.21）d,对照组β-HCG下降到正常所需时间为（45.66±10.29）d,差异具有统计学意义（P〈0.05）。结论腹腔镜监护下吸宫术联合MTX、米非司酮治疗子宫瘢痕处妊娠临床疗效较为理想,能够显著改善患者相关临床症状,成功率高,且恢复速度较快,安全性高。

Objective To investigate the significance of laparoscopic hysterectomy combined with MTX and mifepristone in the treatment of uterine scar pregnancy.Methods 86 patients with uterine scar pregnancy from July 2015 to May 2017 in our hospital were selected as the subjects,were randomly divided into control group and experimental group,each group of 43 cases.The control group was treated with MTX and mifepristone,intramuscular injection of 50 mg/m^2 methotrexate,mifepristone orally,3 times a day.The patients in the experimental group received laparoscopic monitoring,combined with MTX and mifepristone treatment.The hospitalization time,cure rate and vaginal bleeding time of the experimental group and the control group were compared and analyzed.Results The success rate of the experimental group was 100.00%,which was significantly higher than that of the control group（72.42%）,and the difference was statistically significant（P〈0.05）.The vaginal bleeding time in the experimental group was（20.87±6.54） days,significantly shorter than the control group,and the number of days was（34.20±10.89） days,with statistical difference（P〈0.05）.In the experimental group,the time required for the decrease of beta-HCG to normal was（26.90±9.21）,and the time required for the decrease of beta-HCG to normal in the control group was（45.66±10.29）,with statistical difference（P〈0.05）.Conclusion Laparoscopic monitoring uterine aspiration combined with Methotrexate and mifepristone in the treatment of uterine scar pregnancy ideal clinical curative effect,can significantly improve patients＇ clinical symptoms,high success rate,and faster recovery,high safety.