子宫动脉介入栓塞联合清宫术与氨甲蝶呤病灶介入治疗子宫切口妊娠疗效比较

Comparison of uterine artery interventional embolization combined with curettage and methotrex-ate intervention in the treatment of uterine incision pregnancy

目的 比较子宫动脉介入栓塞联合清宫术与氨甲蝶呤病灶介入治疗子宫切口妊娠的效果.方法 选择2014年7月至2016年7月医院诊治的剖宫产子宫切口妊娠患者172例,按照随机数表法将入选患者分为两组,每组86例,对照组采用氨甲蝶呤病灶介入治疗,观察组采用子宫动脉介入栓塞联合清宫术,比较两组患者的治疗成功率、不良反应发生率及各项指标变化情况.结果 观察组患者治疗成功率（89.53％）明显高于对照组,不良反应发生率明显低于对照组,差异有统计学意义（P〈0.05）;观察组患者治疗时间、血人绒毛膜促性腺激素（β-HCG）恢复正常值时间、月经恢复正常时间均明显短于对照组,差异有统计学意义（P〈0.05）;观察组患者总出血量明显少于对照组,差异有统计学意义（P〈0.05）.结论 子宫动脉介入栓塞联合清宫术比氨甲蝶呤病灶介入治疗不良反应少成功率高,且术后恢复较快,能有效改善患者生活质量.

Objective To compare the curative effects of uterine artery embolisation （UAE） combined with complete curettage of uterine cavity and methotrexate in interventional treatment of cesare-an scar pregnancy （CSP）. Methods One hundred and seventy-two CSP patients in hospital from July 2014 to July 2016 were selected and divided into two groups according to random number table method, with 86 cases in each group. Patients in control group were given interventional treatment with methotrex-ate,while patients in observation group were given UAE combined with complete curettage of uterine cav-ity. The success rate,incidence of adverse reactions,changes of indexes were compared between the two groups. Results The success rate of observation group （89. 53%）was higher than that of control group, and the incidence of adverse reactions was lower than that of control group （P 〈 0. 05）;the curative time,time of blood β-HCG back to normal value,time of menstruation back to normal of the patients in observation group were shorter than those of the control group,the differences were significant （P 〈0. 05）;the total bleeding volume in observation group was less than that in control group （P 〈 0. 05）. Conclusions UAE combined with complete curettage of uterine cavity has higher success rate of treat-ment,it has quick recovery has less adverse reactions compared with methotrexate interventional treat-ment,which can effectively improve living quality of patients.