甲氨蝶呤妊娠囊内注射联合米非司酮口服在子宫瘢痕妊娠治疗中的应用

Application of Methotrexate Intracapsular Injection Combined with Mifepristone Oral in the Treatment of Uterine Scar Pregnancy

目的观察与研究甲氨蝶呤妊娠囊内注射联合米非司酮口服在子宫瘢痕妊娠治疗中的应用效果。方法在特定时间段内(2017年10月—2019年10月)方便选取78例子宫瘢痕妊娠患者,对入选研究对象进行随机编号(1~78号),1~39号采取甲氨蝶呤肌肉注射联合米非司酮口服治疗(对比组,n=39),40~78号给予甲氨蝶呤妊娠囊内注射联合米非司酮口服治疗(研究组,n=39),比较治疗成功率、β-HCG水平、治疗指标。结果研究结果显示,研究组治疗成功率(97.44%)高于对比组(84.62%)(χ2=3.924,P=0.048<0.05);治疗前、两组β-HCG水平差异无统计学意义(t=0.823,P=0.413>0.05),治疗后,不同时期两组β-HCG水平均有所降低,但是,研究组降低幅度更加显著,研究组治疗2 d、5 dβ-HCG水平低于对比组(t=15.056、11.426,P=0.000、0000<0.05);研究组阴道出血量少于对比组,住院时间、β-HCG水平转阴时间均短于对比组(t=7.741、7.938、8.727,P=0.000、000、000<0.05)。结论给予子宫瘢痕妊娠患者甲氨蝶呤妊娠囊内注射联合米非司酮口服治疗,治疗成功率较高,β-HCG水平降低明显,阴道出血量少,住院时间、β-HCG水平转阴时间短,应用效果与价值理想。

Objective To observe and study the effect of methotrexate intracapsular injection combined with oral mifepristone in the treatment of uterine scar pregnancy.Methods In a specific period of time(October 2017-October 2019),78 pregnant patients with uterine scars were convenient selected,and the selected subjects were randomly numbered(No.1-78),and methotrexate muscles injection combined with oral mifepristone(comparative group,n=39)were taken on No.1-39,No.40-78 were given methotrexate intraperitoneal injection combined with oral mifepristone(research group,n=39),and the treatment success rate was compared,β-HCG levels,treatment indicators.Results The results showed that the treatment success rate of the study group(97.44%)was higher than that of the control group(84.62%)(χ2=3.924,P=0.048<0.05);there was no statistically significant difference inβ-HCG levels between the two groups before treatment(t=0.823,P=0.413>0.05),after treatment,the levels ofβ-HCG in the two groups decreased in different periods,but the reduction in the study group was more significant,and the levels ofβ-HCG in the study group for 2 d and 5 d were lower than the control group(t=15.056,11.426,P=0.000,0000<0.05);the vaginal bleeding volume of the study group was less than that of the control group,and the hospitalization time andβ-HCG level negative time were shorter than that of the control group(t=7.741,7.938,8.727,P=0.000,000,000<0.05).Conclusion Intrauterine injection of methotrexate in pregnant women with uterine scar pregnancy combined with oral treatment of mifepristone,the treatment has a higher power,theβ-HCG level decreases significantly,the vaginal bleeding is less,the hospitalization time,the time ofβ-HCG level turning negative is short,the application effect and value are ideal.