子宫动脉栓塞术与甲氨蝶呤治疗对瘢痕妊娠子宫出血患者子宫动脉血流动力学指标及不良反应的影响

Effect of Uterine Artery Embolization and Methotrexate Treatment on Uterine Artery Hemodynamic Indices and Adverse Effects in Patients with Uterine Bleeding in Scar Pregnancy

目的分析子宫动脉栓塞术与甲氨蝶呤治疗对瘢痕妊娠子宫出血患者子宫动脉血流动力学指标及不良反应的影响。方法随机选取2019年1月-2021年12月期间厦门大学附属福州第二医院妇产科治疗的60例瘢痕妊娠子宫出血患者,依据患者的治疗方式差异将其分入观察组(30例)和对照组(30例),对照组患者采用子宫动脉栓塞术治疗,观察组患者应用甲氨蝶呤与子宫动脉灌注栓塞化疗术。比较两组止血总有效率、并发症发生情况、子宫动脉血流动力学指标、卵巢内分泌功能。结果两组止血总有效率、平均操作时间相比,差异无统计学意义(P>0.05),观察组术中出血量(105.12±11.98)mL,明显低于对照组(174.23±13.95)mL,住院时间(8.64±1.76)d,明显短于对照组(11.92±1.79)d,差异有统计学意义(t=20.586、7.157,P<0.001);观察组并发症发生率均明显低于对照组,差异有统计学意义(P<0.05)。观察组子宫动脉血流动力学指标、卵巢内分泌功能明显优于对照组,差异有统计学意义(P<0.05)。结论子宫动脉栓塞术与对瘢痕妊娠子宫出血患者应用甲氨蝶呤治疗和子宫动脉栓塞术均能够获得良好的止血效果,而采用甲氨蝶呤治疗更有利于减少出血量,促进子宫动脉血流动力学指标改善,并减少并发症发生。

Objective To analyze the effects of uterine artery embolization and methotrexate treatment on uterine artery hemodynamic indexes and adverse effects in patients with uterine bleeding in scar pregnancy.Methods Sixty patients with uterine bleeding in scar pregnancy treated in the Department of Obstetrics and Gynecology of the Second Hospital of Fuzhou,Xiamen University from January 2019 and December 2021 were randomly selected.The patients were divided into an observation group(30 cases)and a control group(30 cases)based on the differences in their treatment modalities.Patients in the control group were treated with uterine artery embolization,while patients in the observation group were treated with methotrexate and uterine artery perfusion embolization chemotherapy.The total effective rate of hemostasis,complications,uterine artery hemodynamics and ovarian endocrine function were compared between the two groups.Results There was no statistically significant difference in the total efficiency of hemostasis and mean operation time between the two groups(P>0.05).The amount of intraoperative bleeding in the observation group(105.12±11.98)mL was significantly lower than that in the control group(174.23±13.95)ml,and the hospital stay(8.64±1.76)d was significantly shorter than that in the control group(11.92±1.79)d,the difference was not statistically significant(t=20.586,7.157,P<0.001).The incidence of complications in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).The uterine artery hemodynamic index and ovarian endocrine function in the observation group was significantly better than that in the control group,the difference was not statistically significant(P<0.05).Conclusion Both methotrexate treatment and uterine artery embolization in patients with uterine bleeding in scar pregnancy can achieve good hemostatic effect,and the use of methotrexate treatment is more beneficial to reduce bleeding volume,promote improvement of uterine artery hemodynamic indexes and reduce complications.