甲氨蝶呤联合米非司酮治疗剖宫产术后子宫切口部位妊娠的临床效果观察

Clinical observation of conservative treatment of uterine incisionpregnancy after cesarean section

目的:观察并分析对剖宫产术后子宫切口部位妊娠患者采用保守治疗的临床效果。方法:将我院自2014年2月至2017年1月期间收治的62例剖宫产术后子宫切口部位妊娠患者作为研究对象,按照治疗方式的不同分为每组31例的对照组(甲氨蝶呤)和实验组(甲氨蝶呤联合米非司酮),将两组患者治疗的临床疗效进行对比,以评估保守治疗对于剖宫产术后子宫切口部位妊娠患者的临床效果。结果:采用甲氨蝶呤联合米非司酮对患者治疗的实验组临床有效率高达87.1%,显著高于甲氨蝶呤单药治疗的对照组患者(61.3%),差异有统计学意义(P<0.05);相比于甲氨蝶呤单药治疗,联合使用米非司酮可以显著降低患者β-HCG水平、减少患者阴道出血量并缩短患者住院时间,差异均有统计学意义(P<0.05)。结论:对剖宫产术后子宫切口部位妊娠患者,可以选择甲氨蝶呤联合米非司酮对患者进行保守治疗,临床效果显著,且患者术后恢复快,建议临床推广。

Objectives： To observe and analyze the clinical effect of conservative treatment for uterine incisional pregnancy after cesarean section. Methods： Sixty-two patients with uterine incisional pregnancy after cesarean section from February 2014 to January 2017 were enrolled in this study. According to the different treatment methods,they were divided into control group（ methotrexate） and experimental group（ methotrexate combined with mifepristone）,with 31 cases in each group. The clinical efficacy of two groups were compared to assess the clinical effect. Results： The clinical effective rate in experimental group was 87. 1%,which was significantly higher than that of control group（ 61. 3%）,with statistically significant difference（ P〈0. 05）. Compared to methotrexate treatment,combined use of mifepristone and methotrexate can significantly reduce the patient＇s β-HCG levels,reduce vaginal bleeding in patients and shorten the hospital stay,with statistically significant difference（ P〈0. 05）.Conclusion： Methotrexate combined with mifepristone can be chosen as a conservative treatment for patients with uterine incision pregnancy after cesarean section,which is of significnant clinical effect.