两种方法治疗内生型剖宫产瘢痕妊娠的效果对比

Efficacy of two different therapies for endogenous cesarean scar pregnancy: a comparative study

目的比较两种方法治疗内生型剖宫产瘢痕妊娠(CSP)的效果。方法回顾性分析47例内生型CSP患者的临床资料,其中16例(A组)采用孕囊穿刺抽吸+氨甲蝶呤注射+B超监测下行清宫术,31例(B组)子宫动脉栓塞术+B超监测下行清宫术治疗。比较两组患者行清宫术时的出血量、治疗后血β-人绒毛膜促性腺激素(β-hCG)下降值、血β-hCG下降速率、住院时间、住院费用及术后并发症发生情况。结果两组患者血β-hCG下降值、血β-hCG下降速率、清宫时出血量及住院时间相比较,差异均无统计学意义(均P>0.05)。A组患者住院费用少于B组(P<0.01)。两组患者术后均无子宫破裂、大量出血等并发症发生。结论孕囊穿刺抽吸+甲氨喋呤注射+B超监测下行清宫术治疗CSP安全、有效,且更为经济。

Objective To compare the effects of two different treatments on endogenous cesarean scar pregnancy (CSP). Methods The clinical data of 47 patients with endogenous CSP were retrospectively analyzed,including 16 cases (group A) treated with gestational sac aspiration+methotrexate injection+ultrasound-guided suction curettage and 31 cases (group B) with uterine artery embolization+ultrasound-guided suction curettage.Blood loss during curettage, post-treat ment blood β-human chorionic gonadotropin(β-hCG) decline,blood β-hCG decline rate,hospital stay,hospitalization costs,and incidence of postoperative complications were compared between the two groups. Results There was no statistically significant difference between the two groups in blood β-hCG decline,blood β-hCG decline rate,blood loss during curettage , or hospital stay(all P >0.05).Group A achieved less hospitalization costs than group B( P <0.05). No postoperative complications occurred in the two groups,such as uterine rupture and massive bleeding. Conclusion Gestational sac aspiration +methotrexate injection+ultrasound-guided suction curettage is safe and effective in the treatment of endogenous CSP,achieving less hospitalization costs.