米非司酮联合清宫术治疗Ⅰ型剖宫产瘢痕妊娠的疗效及安全性分析

Efficacy and Safety Analysis of Mifepristone Combined with Uterine Evacuation in the Treatment of TypeⅠCesarean Section Scar Pregnancy

目的探究Ⅰ型剖宫产瘢痕妊娠患者接受米非司酮联合清宫术治疗的疗效与安全性。方法方便选取该院在2017年1月—2020年10月接收的85例患者为该次研究对象,以患者入院顺序为依据实施分组,接受清宫术治疗患者为对照组(42例),接受米非司酮联合清宫术治疗患者为观察组(43例),比较组间血β-HCG等指标差异,计算总有效率与不良反应发生率。结果观察组阴道出血时间(5.31±1.33)d、住院时间(11.58±3.04)d、术后30 d血β-HCG(7.16±10.65)mIU/mL,均少于对照组,差异有统计学意义(t=11.714、4.112、11.316,P<0.05)。观察组总有效率88.37%,高于对照组的69.05%,差异有统计学意义(χ^(2)=4.753,P<0.05)。观察组发生呕吐、肝功能异常等不良反应患者5例,发生率11.63%,低于对照组,差异有统计学意义(χ^(2)=5.767,P<0.05)。结论Ⅰ型剖宫产瘢痕妊娠患者经米非司酮联合清宫术治疗,达到理想治疗效果,患者术后安全性较高。

Objective To explore the efficacy and safety of mifepristone combined with uterine evacuation in typeⅠcesarean section scar pregnancy patients.Methods 85 patients received in the hospital from January 2017 to October 2020 were convenient selected as the observation objects of this study.Groups were implemented based on the order in which the patients were admitted to the hospital.Patients who received uterine evacuation were selected as the control group(42 cases).The patients treated with mifepristone combined with uterine evacuation were the observation group(43 cases).The differences in bloodβ-HCG and other indicators between the groups were compared,and the total effective rate and the incidence of adverse reactions were calculated.Results The time of vaginal bleeding in the observation group(5.31±1.33)d,hospitalization time(11.58±3.04)d,and bloodβ-HCG(7.16±10.65)mIU/mL on the 30 d postoperative day were less than those of the control group,the difference were statistically significant(t=11.714,4.112,11.316,P<0.05).After clinical treatment,the total effective rate of the observation group was 88.37%,which was higher than 69.05%in the control group,the difference was statistically significant(χ^(2)=4.753,P<0.05).There were 5 patients in the observation group with adverse reactions such as vomiting and abnormal liver function,the incidence was 11.63%,which was lower than that of the control group,the difference was statistically significant(χ^(2)=5.767,P<0.05).Conclusion Mifepristone combined with uterine evacuation treatment for patients with type I cesarean section scar pregnancy achieves the ideal therapeutic effect,and the postoperative safety was relatively high.