MTX联合HIFU治疗剖宫产瘢痕部位妊娠的临床研究

Clinical Research of Cesarean Scar Pregnancy Treated with MTX Combined HIFU

目的评价甲氨蝶呤(MTX)联合高强度聚焦超声(HIFU)治疗剖宫产瘢痕部位妊娠的临床疗效。方法回顾性分析我院2011年至2015年收治的剖宫产瘢痕部位妊娠病例22例,其中MTX联合米非司酮治疗(药物组)10例,MTX联合HIFU治疗(HIFU组)12例,比较两组患者的临床疗效。结果 MTX联合HIFU治疗组12例全部保守治疗成功,MTX联合米非司酮组仅4例保守治疗成功结论,两组比较差异有统计学意义(P<0.05);HIFU组清宫术中出血量、清宫术后阴道流血时间、血hcg恢复至正常时间、月经复潮时间及住院时间均较药物组少,差异有统计学意义(P<0.05)。结论 MTX联合HIFU消融治疗剖宫产瘢痕部位妊娠较甲氨蝶呤联合米非司酮疗效好,是一种安全、有效、无创的治疗方案,值得推广运用。

Objective To evaluate clinical curative effect of cesarean scar pregnancy treated with methotrexate （MTX） combined high-intensity focused ultrasound （HIFU）. Methods 22 cases of cesarean section scar pregnancy treated in our hospital from 2011 to 2015 were retrospectively analyzed to compare the clinical efficacy of two groups including 10 cases treated with MTX combined mifepristone（Drug） and 12 cases treated with MTX combined HIFU（HIFU）. Results 12 cases in MTX combined HIFU treatment group were all successfully conservative treated, while MTX combined mifepristone group only had 4 cases successful conservative treatment conclusion and the difference between two groups was statistically significant （ P 〈 0. 05 ） ; Blood loss during complete curettage of uterine cavity, postoperative vaginal bleeding time, blood HCG recover normal time, return of menses and hospital stay were less than drug group and the difference was statistically significant （ P 〈 0.05 ）. Conclusion MrI＇X combined HIFU ablation as treatment of cesarean scar pregnancy has better curative effect compared with methotrexate combined mifepristone and it＇s a kind of safe, effective and noninvasive treatment which is worth promoting application.