甲氨蝶呤预处理联合超声清宫术治疗剖宫产术后子宫瘢痕妊娠对照观察

Controlled observation of methotrexate pretreatment combined with ultrasonic uterine curettage in the treatment of uterine scar pregnancy after cesarean section

目的探讨甲氨蝶呤预处理联合超声监视下清宫术治疗剖宫产术后子宫瘢痕妊娠的临床疗效及安全性。方法将116例剖宫产术后子宫瘢痕妊娠患者按治疗方案不同分为两组,每组58例。对照组采取超声监视下清宫术治疗,研究组采取甲氨蝶呤预处理联合超声监视下清宫术治疗,比较两组临床疗效、术中失血量、康复时间、血清β人绒毛膜促性腺激素水平恢复正常时间、病灶吸收时间、住院时间、月经恢复时间、并发症发生率。结果研究组总有效率显著高于对照组(P<0.05),术中失血量显著少于对照组(P<0.01),血清β人绒毛膜促性腺激素水平恢复正常时间、病灶吸收时间、康复时间、住院时间、月经恢复时间均显著短于对照组(P<0.01)。两组并发症总发生率比较差异无统计学意义(P>0.05)。结论甲氨蝶呤预处理联合超声监视下清宫术治疗剖宫产术后子宫瘢痕妊娠疗效确切,能有效减少手术创伤,促进身体康复,安全性较高。

Objective To observe the clinical efficacy and safety of methotrexate pretreatment combined with ultrasound-monitored uterine evacuation in the treatment of uterine scar pregnancy after cesarean section.Methods A total of 116 patients with uterine scar pregnancy after cesarean section were divided into two groups according to different treatment plans,with 58 cases in each group.The control group was treated with ultrasound-monitored uterine evacuation,and the study group was treated with methotrexate pretreatment combined with ultrasound-monitored uterine evacuation.The clinical efficacy of the two groups was compared.Intra`tive blood loss,rehabilitation time,time taken forβ-human chorionic gonadotropin(β-hCG)level returned to normal,time taken for absorption of lesions,length of hospital stays,time taken for menstrual recovery,and incidence of complications were compared between the two groups.Results The total effective rate of the study group was higher than that of the control group(P<0.05).The blood loss of the study group was less than that of the control group(P<0.01).The time taken for serumβ-hCG level to return to normal,the time taken to absorb the lesion,rehabilitation time,the time of hospitalization,and the time taken to recover menstruation were significantly shorter than those of the control group(P<0.01).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusions Methotrexate pretreatment combined with ultrasound-monitored uterine evacuation for the treatment of uterine scar pregnancy after cesarean section has a definite effect,can effectively reduce surgical trauma,promote physical recovery,and has high safety.