子宫动脉甲氨蝶呤灌注及栓塞联合米非司酮治疗瘢痕子宫切口妊娠的疗效

Clinical Effect of Uterine Artery Methotrexate Perfusion and Embolization Combined with Mifepristone in Treatment of Scarred Uterus Pregnancy

目的:分析子宫动脉甲氨蝶呤灌注及栓塞联合米非司酮治疗瘢痕子宫切口妊娠的临床疗效。方法:选取射阳县人民医院2013年1月—2021年1月收治的80例瘢痕子宫患者,随机分为对照组和观察组,各40例。对照组实施米非司酮联合米索前列醇治疗,观察组实施子宫动脉甲氨蝶呤灌注加栓塞后联合米非司酮治疗,两组治疗后清宫。比较两组手术情况、预后情况、子宫动脉血流动力学指标、卵巢功能。结果:观察组手术时间、术中出血量、住院时间、血清人绒毛膜促性腺激素恢复正常时间、瘢痕处包块消失时间、月经恢复时间均明显低于于对照;观察组子宫动脉血流动力学血流波动指数、阻力指数明显高于对照组;卵泡刺激素(FSH)是促进卵巢发育和卵泡成熟的主要激素,测量FSH具有不同的临床指导意义,雌二醇(E2)是由卵巢合成的主要雌激素,对女性维持正常生殖系统功能有关键意义,观察组黄体生成素、FSH、E2均明显高于对照组,差异均有统计学意义(P<0.05)。结论:子宫动脉甲氨蝶呤灌注及栓塞联合米非司酮治疗瘢痕子宫切口妊娠对患者的创伤小,安全性高,有利于术后尽快恢复,是一种安全、有效的治疗方法。该治疗方法成功率高,治疗时间短,住院时间短,值得在临床应用中推广。

Objective:To analyze the clinical effect of uterine artery methotrexate perfusion and embolization combined with Mifepristone in the treatment of cicatricial uterine incision pregnancy.Methods:80 patients with cicatricial uterus admitted to Sheyang County People's Hospital from January 2013 to January 2021 were randomly divided into control group and observation group,with 40 cases in each group.The control group was treated with mifepristone combined with misoprostol,and the observation group was treated with uterine artery methotrexate infusion combined with embolization combined with mifepristone,and the two groups were cleared after treatment.Operation,prognosis,uterine arterial hemodynamics and ovarian function were compared between the two groups.Results:Compared with the control group,the time of operation,the amount of bleeding during operation,the time of hospitalization,the recovery of serum Chorionic gonadotropin,the normal time,the disappearance of Scar Mass and the recovery time of menstruation in the observation group were significantly shorter than those in the control group The Hemodynamics PI and RI of uterine arteries in the observation group were significantly higher than those in the control group,and FSH was the major hormone for ovarian development and follicular maturation,E2 is the main estrogenic hormone synthesized by ovary,which has a key significance in maintaining normal reproductive system function in women.LH,FSH and E2 in the observation group were significantly higher than those in the control group(P<0.05).Conclusion:Uterine artery methotrexate perfusion and embolization combined with Mifesterone in the treatment of pregnancy with cicatricial uterine incision has less trauma,high safety,and is conducive to postoperative recovery,which is a safe and effective treatment method.This treatment method has high success rate,short treatment time and short hospitalization time,which is worthy of promotion in clinical application.