超声介入引导下甲氨蝶呤局部注射联合口服米非司酮治疗子宫瘢痕妊娠的疗效观察

Clinical effect analysis of the topical injection of methotrexate guided by ultrasound combined with oral mifepristone in the treatment of cesarean scar pregnancy

目的:探讨超声介入引导下甲氨蝶呤局部注射联合口服米非司酮治疗子宫瘢痕妊娠的有效性及安全性。方法:选取子宫瘢痕妊娠病人54例,随机分为2组,对照组使用口服米非司酮进行治疗,观察组在此基础上联合超声介入引导下甲氨蝶呤妊娠囊内局部注射进行治疗,同时对2组病人后续采取清宫治疗。对2组病人临床治疗效果、不良反应、治疗有效率进行统计。结果:观察组病人住院时间、hCG转阴时间、体内病灶消失时间及月经恢复时间均优于对照组(P<0.01),术中出血量少于对照组(P<0.01);观察组病人心悸、恶心、腹部疼痛等总不良反应率低于对照组(P<0.01),治疗的有效率高于对照组(P<0.05)。结论:对子宫瘢痕妊娠病人使用超声介入引导下甲氨蝶呤局部注射联合口服米非司酮进行治疗,可以有效地提高病人的临床治疗效果,减少不良反应发生率,提高治疗的有效率,值得临床推广。

Objective:To investigate the efficacy and safety of the local injection of methotrexate guided by ultrasound combined with oral mifepristone in the treatment of cesarean scar pregnancy. Methods:Fifty-four patients with cesarean scar pregnancy were randomly divided into the control group and observation group.The control group was treated with oral mifepristone,and the observation group was treated with the local injection of methotrexate guided by ultrasound combined with oral mifepristone based on the control group.At the same time,two groups were treated with cesarean curettage.The clinical therapeutic effect,adverse reactions and effective rate of treatment between two groups were statistically analyzed. Results:The time of hospitalization,time of hCG turning negative,time of disappearance of internal lesions and time of menstrual recover in observation group were better than those in control group( P <0.01),and the intraoperative blood loss in observation group was less than that in control group( P <0.01).The incidence rate of total adverse reactions,such as palpitation,nausea and abdominal pain,in observation group was lower than that in control group( P <0.01),and the effective rate of treatment in observation group was higher than that in control group( P <0.05). Conclusions:The local injection of methotrexate guided by ultrasound combined with oral mifepristone in the treatment of cesarean scar pregnancy can effectively improve the clinical efficacy,and reduce the incidence rate of adverse reactions,which is worthy of promotion in clinical practice.