甲氨蝶呤联合宫腔镜手术治疗内生型剖宫产瘢痕妊娠的临床效果分析

Analysis on Clinical Effect of Methotrexate Combined with Hysteroscopy Surgery in Treatment of Endogenous Cesarean Scar Pregnancy

目的:分析甲氨蝶呤联合宫腔镜手术治疗内生型剖宫产瘢痕妊娠的临床效果。方法:选取2021年10月—2023年10月白银市第一人民医院妇科收治的内生型剖宫产瘢痕妊娠患者70例作为研究对象,随机分为参照组、试验组,各35例。参照组实施宫腔镜手术治疗,试验组采用甲氨蝶呤联合宫腔镜手术治疗。对比两组治疗效果。结果:试验组住院时间短于参照组,术中出血量少于参照组,包块消失时间、人绒毛膜促性腺激素β亚单位(β-HCG)恢复正常时间、月经复潮时间早于参照组(P<0.05)。术后1、3 d,两组疼痛评分低于术前,且试验组低于参照组(P<0.05)。术后1、3、6、12 d,两组β-HCG水平低于术前,且试验组低于参照组(P<0.05)。手术前后,两组雌二醇、黄体生成素、卵泡刺激素水平无明显差异(P>0.05)。试验组治疗总有效率高于参照组(P<0.05)。结论:甲氨蝶呤联合宫腔镜手术治疗内生型剖宫产瘢痕妊娠的临床效果较好,能够减轻术后疼痛,改善β-HCG水平,促进患者康复。

Objective:To analyze the clinical effect of methotrexate combined with hysteroscopy surgery in the treatment of endogenous cesarean scar pregnancy.Methods:A total of 70 patients with endogenous cesarean scar pregnancy who were admitted to the Gynecology Department at the First People's Hospital of Baiyin from October 2021 to October 2023 were selected as the study subjects.They were randomly divided into a reference group and an experimental group,with 35 cases in each group.The reference group received hysteroscopy surgery treatment,while the experimental group received methotrexate combined with hysteroscopy surgery treatment.The treatment effects of the two groups were compared.Results:The length of hospital stay in the experimental group was shorter than that in the reference group,the intraoperative blood loss in the experimental group was less than that in the reference group,the time of mass disappearance,the time forβsubunit of human chorionic gonadotropin(β-HCG)returning to normal level,and the time of menstruation relapse in the experimental group were earlier than those in the reference group(P<0.05).On 1 d and 3 d after surgery,the pain scores in the two groups were lower than those before surgery,and the pain scores in the experimental group were lower than those in the reference group(P<0.05).On 1 d,3 d,6 d,and 12 d after surgery,the levels ofβ-HCG in the two groups were lower than those before surgery,and the levels in the experimental group were lower than those in the reference group(P<0.05).There was no significant difference in the levels of estradiol,luteinizing hormone and follicle-stimulating hormone between the two groups before and after surgery(P>0.05).The total effective rate of treatment in the experimental group was higher than that in the reference group(P<0.05).Conclusion:Methotrexate combined with hysteroscopy surgery has a good clinical effect in the treatment of endogenous cesarean scar pregnancy,and can relieve postoperative pain,improve the level ofβ-HCG,and promote the recovery of patients.