甲氨蝶呤介入治疗剖宫产术后子宫瘢痕妊娠的临床观察
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篇名: 甲氨蝶呤介入治疗剖宫产术后子宫瘢痕妊娠的临床观察
TITLE:
摘要: 目的:观察甲氨蝶呤介入治疗剖宫产术后子宫瘢痕妊娠(CSP)的疗效和安全性。方法:40例CSP妇女随机分为对照组(20例)和观察组(20例)。对照组妊娠妇女给予甲氨蝶呤注射液1 mg/kg,肌内注射,每日1次;米非司酮片25 mg,口服,每日2次,均连用5 d。观察组妊娠妇女给予甲氨蝶呤注射液50 mg,经子宫动脉注入后用明胶海绵栓塞。两组妊娠妇女给药结束后检查血人绒毛膜促性腺激素(β-HCG)值,待β-HCG值降至≤2 000 U/L后行清宫术;血β-HCG值>2 000 U/L者继续予以口服米非司酮片25 mg,每日2次,至血β-HCG值降至≤2 000 U/L后行清宫术。观察两组妊娠妇女清宫出血量、确诊距手术间隔时间、术后血β-HCG值恢复正常所需时间,记录不良反应发生情况。结果:观察组妊娠妇女清宫出血量显著低于对照组,确诊距手术间隔时间、术后血β-HCG值恢复正常所需时间显著短于对照组,差异均有统计学意义(P<0.05)。两组妊娠妇女治疗期间均未见明显不良反应发生。结论:甲氨蝶呤介入治疗CSP可有效减少清宫出血,缩短清宫手术等待时间及血β-HCG值恢复至正常的时间,且安全性较好。
ABSTRACT: OBJECTIVE: To observe the efficacy and safety of methotrexate in the interventional treatment of cesarean scar pregnancy (CSP). METHODS: 40 CSP women were randomly divided into control group (20 cases) and observation group (20 cases). Control group pregnant women received methotrexate 1 mg/kg, intramuscular injection, once a day; mifepristone 25 mg, orally, twice a day, for 5 d. Observation group pregnant women received methotrexate 50 mg, gelatin sponge embolization was conducted after uterine artery injection. Human chorionic gonadotropin (β-HCG) value was detected after administration, then curettage was conducted until β-HCG value decreased to less than or equal to 2 000 U/L; pregnant women still received mifepristone 25 mg if β-HCG value was higher than 2 000 U/L, then curettage was conducted until β-HCG value decreased to less than or equal to 2 000 U/L. The amount of bleeding, time distance to curettage, the time of β-HCG value to normal in 2 groups were observed, and the incidence of adverse reactions was recorded. RESULTS: The amount of bleeding in observation group was significantly lower than control group, time distance to curettage and the time of β-HCG value to normal were significantly shorter than control group, with statistical significances(P<0.05). And there were no obvious adverse reactions in 2 groups. CONCLUSIONS: Methotrexate can effectively reduce the bleeding in the interventional treatment of CSP, shorten the time distance of diagnosed to curettage and the time of β-HCG value to normal, with good safety.
期刊: 2016年第27卷第36期
作者: 林娟,闫咨儒
AUTHORS: LIN Juan,YAN Ziru
关键字: 剖宫产术后子宫瘢痕妊娠;介入治疗;甲氨蝶呤;清宫术
KEYWORDS: Cesarean scar pregnancy; Interventional treatment; Methotrexate; Curettage
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