甲氨蝶呤联合米非司酮先期干预治疗内生型剖宫产瘢痕部位妊娠的临床疗效

Clinical effect of methotrexate combined with mifepristone for pregnancy at scar site of endogenic cesarean section

目的探讨甲氨蝶呤联合米非司酮先期干预治疗内生型剖宫产瘢痕部位妊娠的临床疗效。方法选取成都市双流区第一人民医院2016年12月—2017年12月收治的内生型剖宫产瘢痕部位妊娠患者60例,随机分为对照组与干预组,各30例。对照组患者予以宫腔镜下刮宫术治疗,干预组患者于术前给予甲氨蝶呤联合米非司酮治疗,再进行宫腔镜下刮宫术治疗。比较两组患者治疗成功率、术中出血量、人绒毛膜促性腺激素(HCG)下降25%以上所用时间,并观察两组患者不良反应发生情况。结果干预组患者治疗成功率高于对照组,术中出血量少于对照组,HCG下降25%以上所用时间短于对照组,不良反应发生率低于对照组(P<0.05)。结论甲氨蝶呤联合米非司酮先期干预治疗内生型剖宫产瘢痕部位妊娠的临床疗效确切,可提高治疗成功率,减少术中出血量,较短时间内降低HCG水平,且安全性较高。

Objective To observe the clinical effect of methotrexate combined with mifepristone for pregnancy at scar site of endogenous cesarean section.Methods A total of 60 cases of patients with pregnancy at scar site of endogenic cesarean section were selected from December 2016 to December 2017 in Shuangliu District First People's Hospital,which were randomly divided into control group and intervention group,30 cases in each group.The control group was treated with hysteroscopic curettage,the intervention group was treated with methotrexate combined with mifepristone before operation, and then underwent hysteroscopic curettage.The success rate of treatment,intraoperative blood loss,the time of HCG down by more than 25% were compared between the two groups,and the incidence of adverse reactions were observed.Results The intervention group of success rate of treatment was higher than control group,intraoperative blood loss was less than control group,the time of HCG down by more than 25% was shorter than control group,incidence rate of adverse reations was lower than control group(P<0.05).Conclusion Methotrexate combined with mifepristone have an exact clinical effect for pregnancy at scar site of endogenic cesarean section,it can improve the treatment success rate,reduce the intraoperative blood loss, reduce the HCG level in a short time,and with high safety.