子宫动脉MTX化疗栓塞联合清宫治疗剖宫产术后疤痕处妊娠28例

Efficacy Analysis of 28 Cases of Cesarean Scar Pregnancy Treated with Uterine Artery MTX Chemoembolization Combined with Ultrasound-guided Curettage

目的:观察子宫动脉MTX化疗栓塞联合超声引导清宫治疗剖宫产术后子宫疤痕处妊娠的临床疗效。方法:收集从2013年1月至2017年1月期间来医院进行治疗剖宫产术后子宫疤痕处妊娠的患者病例54例,随机抽取分为观察组28例和对照组26例,术后随访半年。对照组为子宫动脉栓塞术后3d行B超定位下清宫术,观察组为子宫动脉MTX化疗栓塞术后3d后再行B超定位下清宫术。观察两组患者血β-HCG降至正常的时间、清宫术中出血量、再次清宫次数及月经恢复时间。结果:观察组血β-HCG降至正常时间、清宫术出血量、月经恢复时间,再次清宫次数均显著短于对照组(P<0.05)。观察组的治愈率明显高于对照组,差异具有统计学意义(P<0.05)。结论:子宫动脉MTX化疗栓塞联合B超定位下清宫治疗剖宫产瘢痕妊娠是一种安全、有效的保守治疗方法。

Objective:To explore the clinical efficacy of uterine artery MTX chemoembolization combined with ultrasound-guided curettage in treatment of cesarean scar pregnancy.Methods:A total of 54 scar pregnancy cases treated in the People's Second Hospital of Jingzhou from January 2013 to January 2017 had been randomly divided into the observation group(n=28)and the control group(n=26)and had been followed up for half a year.In the control group ultrasound-guided curettage of uterine cavity had been conducted 3 days after uterine artery embolization,while in the observation group3 days after uterine artery MTX chemoembolization.The time for recovery of normal bloodβ-HCG level,the amount of bleeding during curettage of uterine cavity,the times of curettage and the time for recovery of menstruation had been recorded to evaluate clinical therapeutic effects in the two groups.Results:The time for recovery of normal bloodβ-HCG level,the amount of bleeding during complete curettage of uterine cavity,the times of curettage and the time for recovery of menstruation were all significantly less in the observation group than in the control group(P <0.05),while the healing rate of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:Uterine artery MTX chemoembolization combined with ultrasound-guided curettage is a safe and effective method to treat cesarean scar pregnancy.