宫腔镜清宫术治疗前应用甲氨蝶呤联合米非司酮治疗子宫瘢痕妊娠的效果观察

Effects of Intramuscular Injection of MTX and Oral Administration of Mifepristone Combined with Hysteroscopic Uterine Curettage on Cesarean Scar Pregnancy

目的观察肌内注射甲氨蝶呤(MTX)及口服米非司酮联合清宫术治疗子宫瘢痕妊娠的效果。方法纳入2016年1月-2018年10月期间我院64例子宫瘢痕妊娠患者进行研究,采用随机数字表法随机分为观察组、对照组各32例,两组患者均予以MTX肌内注射后实施宫腔镜下的清宫术治疗,观察组在此基础上加以米非司酮口服。比较两组随访情况[血人绒毛膜促性腺激素(β-HCG)水平恢复时间、阴道出血持续时间、月经复潮时间],治疗成功率以及不良反应发生情况。结果两组患者月经复潮时间差异无统计学意义(P>0.05),观察组血β-HCG恢复时间、出血持续时间均短于对照组(P均<0.05);观察组治疗成功率高于对照组(P<0.05),两组不良反应发生率对比差异无统计学意义(P>0.05)。结论宫腔镜清宫术治疗前应用MTX联合米非司酮安全有效,可有助于减少出血,促进恢复。

Objective To observe the effects of intramuscular injection of methotrexate(MTX) and oral administration of mifepristone combined with uterine curettage on cesarean scar pregnancy. Methods A total of 64 patients with cesarean scar pregnancy in our hospital from January 2016 to October 2018 were included in the study and were randomly divided into observation group and control group according to the random number table method, with 32 cases in each group. The two groups were given hysteroscopic uterine curettage after intramuscular injection of MTX, and observation group was additionally given oral administration of mifepristone. The follow-up conditions [recovery time of blood human chorionic gonadotropin(β-HCG) level, duration of vaginal bleeding, menstruation recovery time], treatment success rate and occurrence of adverse reactions were compared between the two groups. Results There was no significant difference in the menstruation recovery time between the two groups(P>0.05), and the recovery time of blood β-HCG and duration of bleeding in observation group were shorter than those in control group(P<0.05). The treatment success rate in observation group was higher than that in control group(P<0.05). There was no significant difference in the incidence rate of adverse reactions between the two groups(P>0.05). Conclusion MTX combined with mifepristone is safe and effective before hysteroscopic uterine curettage, and it can help reduce bleeding and promote recovery.