药物联合预处理在瘢痕妊娠宫腔镜治疗中的临床意义

Clinical significance of combined drug pretreatment in the hysteroscopic treatment of cesarean scar pregnancy

目的:探讨剖宫产瘢痕妊娠患者在宫腔镜手术前孕囊内注入无水乙醇和甲氨蝶呤联合预处理中的临床意义。方法:选取105例剖宫产瘢痕妊娠的患者,按照随机数字表法分成观察组(n=53)和对照组(n=52)。对照组宫腔镜手术前给予孕囊内注入甲氨蝶呤;观察组宫腔镜手术前给予孕囊内注入无水乙醇和甲氨蝶呤混合液,比较两组药物预处理后的临床效果。结果:两组的宫腔镜手术时长、术中出血量、并发症发生率、治疗结局相似,差异均无统计学意义(P>0.05);观察组药物预处理后血β-HCG值下降率、血β-HCG值恢复正常时间均优于对照组,比较差异有统计学意义(P<0.05)。结论:瘢痕妊娠宫腔镜手术前孕囊内注入无水乙醇和甲氨蝶呤混合液可使血β-HCG下降迅速,患者术后恢复快,是局部治疗剖宫产瘢痕妊娠的良好方法。

Objective:To investigate the clinical significance of pretreatment combined with anhydrous ethanol and methotrexate in the gestational sac in patients with cesarean scar pregnancy before hysteroscopic surgery.Methods:105 patients with cesarean scar pregnancy were selected and divided into the observation group(n=53)and control group(n=52)according to random number table method.In the control group,methotrexate was given into the scar pregnancy before hysteroscopic surgery.In the observation group,the mixed solution of anhydrous ethanol and methotrexate was injected into the scar pregnancy before hysteroscopic surgery.The clinical effects of drug pretreatment were compared between the two groups.Results:The hysteroscopic operation duration,intraoperative bleeding volume,complication rate and treatment outcomes were similar between the two groups,with no statistical significance(P>0.05).The decrease rate and the recovery time of bloodβ-HCG value after drug pretreatment in the observation group were better than those in the control group,with a statistically significant difference(P<0.05).Conclusion:The mixed solution of anhydrous ethanol and methotrexate injected into the gestational sac of cesarean scar pregnancy patients before hysteroscopic surgery can make the bloodβ-HCG decreased rapidly and the patients recovered quickly after operation,which is a good method for local treatment of cesarean scar pregnancy patients.