分析宫腔镜联合甲氨蝶呤及米非司酮对子宫切口妊娠患者的疗效及并发症

Analysis of the Efficacy and Complications of Hysteroscopy Combined with Methotrexate and Mifepristone for Patients with Cesarean Scar Pregnancy

目的:分析宫腔镜联合甲氨蝶呤及米非司酮对子宫切口妊娠患者的疗效及并发症。方法:选取2014年1月-2017年1月本院收治的子宫切口妊娠患者40例,与患者及家属说明治疗方案后按照患者及家属的意愿分为对照组与研究组,对照组17例,研究组23例。对照组采用保守治疗即甲氨蝶呤肌肉注射+米非司酮口服,研究组在对照组的基础上在全麻下行宫腔镜手术治疗,比较两组患者的治疗效果及并发症的发生情况。结果:研究组人绒毛膜促性腺激素(β-h CG)下降至正常水平的时间及包块消失的时间明显快于对照组,妊娠终止率明显高于对照组,并发症发生率低于对照组,两组比较差异均有统计学意义(P<0.05)。结论:宫腔镜联合甲氨蝶呤及米非司酮对子宫切口妊娠患者的治疗具有创伤小、恢复快、并发症少、妊娠终止率高等优点,可大大缩短患者的病程,其疗效肯定,值得在临床中推广应用。

Objective:To analyze the efficacy and comlications of hysteroscopy combined with Methotrexate and Mifepristone on cesarean scar pregnancy(CSP).Method:A total of 40 cases on cesarean scar pregnancy in our hospital were selected from January 2014 to January 2017,they were randomly divided into the control group of 17 cases and the study group of 23 cases in accordance with the wishes of patients and their families for treatment.The control group was treated by conservative treatment with Methotrexate Intramuscular Injection+Mifepristone,the study group on the base of that was given hysteroscopic surgery in general anesthesia.The therapeutic results and complications were compared between two groups.Result:Time ofβ-hCG decreased to a normal level and time of the mass disappearance in the study groupwas faster than those in the control group,the rate of termination pregnancy in the study group was significantly higher than that in the control group,the complication rate in the study group was lower than that in the control group,the differences were statistically significant(P<0.05).Conclusion:The treatment of hysteroscopy combined with Methotrexate and Mifepristone on CSP is less trauma,faster recovery,fewer complications,higher rates of termination pregnancy,can greatly shorten the duration of the patient,its efficacy is sure,it is worthy of clinical application.