甲氨蝶呤联合B超引导下清宫治疗流产型剖宫产疤痕妊娠的临床分析

Clinical Analysis of Methotrexate Combined with B-ultrasound Guided Evacuation in the Treatment of Aborted Cesarean Section Scar Pregnancy

目的探究在治疗流产型剖宫产疤痕妊娠中应用甲氨蝶呤联合B超引导下清宫的临床效果,同时分析其临床可用价值。方法选取该院2019年1月-2020年1月62例流产型剖宫产疤痕妊娠产妇的基本资料,按照随机数表形式均分为对照组与研究组,单组样本量为31例。对照组患者采用B超引导下清宫治疗法,研究组患者在此基础上增加甲氨蝶呤配合治疗,对两组患者治疗优良率以及各项手术后指标进行统计,分析组间差异。结果两组患者在手术完成后病情得到控制,研究组患者治疗优良率为93.55%,优于对照组患者的64.52%,差异有统计学意义(χ^(2)=7.883,P=0.004)。研究组患者术中出血量、术后住院时间以及血β-HCG值恢复时间相较于对照组更优,差异有统计学意义(t=65.980、18.480、19.613,P<0.01)。结论在开展B超引导下,清宫治疗流产型剖宫产疤痕妊娠患者时,配合甲氨蝶呤开展治疗,能够缩短患者的住院时间和血β-HCG值恢复时间,降低患者的术中出血量,改善患者治疗优良率,具有高度的可用价值,值得推广。

Objective To explore the clinical effects of methotrexate combined with ultrasound-guided evacuation in the treatment of aborted cesarean scar pregnancy,and to analyze its clinical value.Methods Select the basic data of 62 pregnant women with abortion-type cesarean section scars in the hospital from January 2019 to January 2020,and divide them into the control group and the experimental group according to the random number table method,with 31 cases in a single group.The patients in the control group were treated with uterine clearing under the guidance of B-ultrasound,and the patients in the study group were treated with methotrexate on this basis.The excellent rate of treatment and various postoperative indicators of the two groups were counted to analyze the differences between the groups.Results The conditions of the two groups of patients were controlled after the operation was completed.The excellent rate of treatment in the study group was 93.55%,and the data was better than 64.52%in the control group,the difference was statistically significant(χ^(2)=7.883,P=0.004).After the experiment was completed,the amount of blood loss,postoperative hospital stay and blood β-HCG recovery time in the study group were better than those in the control group,the difference was statistically significant(t=65.980,18.480,19.613,P<0.01).Conclusion Under the guidance of B-ultrasound,when treating aborted cesarean scar pregnancy patients with uterine purgation,the treatment with methotridine can shorten the patient's hospital stay and the time of bloodβ-HCG recorery,reduce the amount of intraoperative blood loss and improve the total effective rate of patient treatment.It has high useful value and is worthy of promotion.