MTX局部用药与全身用药在联合米非司酮治疗剖宫产瘢痕部位妊娠临床疗效对比

摘要

Objective To compare the clinical effects between local and systematic administration of methotrexate (MTX) combined with mifepristone in the treatment of cesarean scar pregnancy.Methods A total of 52 diagnosed cesarean scar pregnancy patients under conservative treatment were randomly divided into observation group and control group, with 26 cases in each group. The observation group received local administration of MTX combined with mifepristone, and the control group received systematic administration of MTX combined with mifepristone. Curative effects of the two groups were compared.Results The observation group had average time of β-human chorionic gonadotropin (β-HCG) decreased time for curettage was (18.0±2.5) d, and that of the control group was (23.0±3.8) d. The difference between the two groups had statistical significance (P<0.05). Incidence of adverse reactions was 11.54% in the observation group, and that was 30.77% in the control group. Their difference had statistical significance (P<0.05).Conclusion Local administration of MTX combined with mifepristone is safe and reliable in treating cesarean scar pregnancy, and it provides faster decreased serum β-HCG speed, more obvious effect, shorter treatment time, and lower incidence of adverse reactions than systematic administration. This method is suitable for wide application in primary hospital.%目的：对比甲氨蝶呤(MTX)局部用药与全身用药在联合米非司酮治疗剖宫产瘢痕部位妊娠方面的临床疗效。方法确诊为剖宫产瘢痕部位妊娠的52例保守治疗患者,随机分为观察组和对照组,每组26例,其中观察组采用MTX局部用药联合米非司酮治疗,对照组采用MTX全身用药联合米非司酮治疗。对比两组的治疗效果。结果观察组血人绒毛膜促性腺激素(β-HCG)下降至可行清宫术所需时间平均为(18.0±2.5)d,对照组血β-HCG下降至可行清宫术所需时间平均为(23.0±3.8)d,两组比较差异有统计学意义(P<0.05)。观察组不良反应发生率为11.54%,对照组不良反应发生率为30.77%,两组比较差异有统计学意义(P<0.05)。结论 MTX局部用药联合米非司酮治疗剖宫产瘢痕部位妊娠安全可靠,血β-HCG下降速度较全身用药更快,效果明显,缩短患者治疗时间,且不良反应发生率比全身用药更低,适合在基层医院临床上广泛应用。