剖宫产瘢痕处妊娠60例不同治疗方法临床研究

Clinical analysis of different treatment of 60 cases of cesarean scar pregnancy

目的:比较两种剖宫产瘢痕处妊娠治疗方案的临床效果。方法:回顾性分析60例剖宫产瘢痕处妊娠患者的临床资料,根据其入院初始治疗方案的不同,分别行米非司酮+甲氨喋呤(MTX)组(A组,28例)、子宫动脉灌注MTX+栓塞组(B组,32例)。结果:米非司酮+MTX组患者的一次治疗成功率为71.4%(20/28),子宫动脉灌注MTX+栓塞组患者的一次治疗成功率为96.9%(31/32),两组患者相比较,差异有统计学意义(χ~2=7.584,P=0.009)。米非司酮+MTX组患者术中出血量、术后β-hCG恢复正常时间、住院时间与子宫动脉灌注MTX+栓塞组患者相比,明显增多,差异有统计学意义(P<0.05)。结论:子宫动脉灌注MTX+栓塞治疗CSP的方案更加有效、经济和安全。

Objective:To investigate the efficiency of two methods in treating patients with cesarean scar pregnancy(CSP).Methods:60 CSP patients who divided into two groups according to method of the treatment were retrospectively analyzed,28 patients were treated with uterine curettage after MTX and mifepristone treatment,while the other 32 patients under went Uterine arterial infusion MTX and embolization therapy combined with uterine curettage.Results:The first treatment success rate of MTX and mifepristone treatment was 71.4%(20/28),The first treatment success rate of Uterine arterial infusion MTX and embolization therapy was 96.9%(31/32),the difference was statistically significant(χ2=7.584,P=0.009).the hemorrhage,time for HCG recovery,duration of hospital stays of patients treated with MTX and mifepristone treatment were significantly increased compare with patients under went Uterine arterial infusion MTX and embolization therapy,the difference was statistically significant(P<0.05).Conclusion:Uterine arterial infusion MTX and embolization therapy could be an effective,economic and safe treatment for Cesarean scar pregnancy.