Objective To investigate the effect of intra-tubal injection of methotrexate(MTX)on cesarean scar pregnancy and its effect on prognosis.Methods A total of 198 cases caesarean scar ectopic pregnancy were selected as research subjects.Among them,98 patients were treated with intra-tubal injection of 30 mg MTX,and were taken as the intervention group.The other 100 patients in the control group were treated with conventional treatment in which intramuscular injection of MTX combined with complete curettage of uterine cavity was performed.The basic information,therapeutic effect of two groups,the short-term and long-term prognosis information was collected,and the curative effect comparison and prognosis evaluation were comple-ted.Results The success rate of intervention group was 97.93％,which was significantly higher than that of the control group(90.85％).The difference was statistically significant(P＜0.05).The average hospitaliza-tion time and disappearance time of the lesion in the intervention group were(10.67 ± 2.36)d and(51.66 ± 8.76)d,while those in the control group were(16.71 ± 2.86)d and(69.16 ± 8.49)d,the ones in the MTX in-tervention group were significantly lower than those in the control group,and the differences were statistically significant(P＜0.05).The results of related prognosis analysis showed that there was no significant differ-ence in short-term prognosis between the two groups(P＞0.05).There was no statistically significant differ-ence between the two groups of the time of β-human chorionic gonadotropin changing to negative and menstru-al recovery time(P＞0.05);the recurrence rate in the intervention group was 2.04％,which was lower than 4.00％in the control group,and the difference was statistically significant(P＜0.05).The pregnancy of the intervention group was 10.20％,which was higher than that of the control group(4％),and the difference was statistically significant(P＜0.05).Conclusion Intra-tubal injection of MTX for cesarean scar treatment has high success rate and long －term prognosis,which is worthy of clinical recommendation.%目的 探讨输卵管内注射氨甲蝶呤(MTX)介入治疗对于剖宫产瘢痕妊娠的疗效,以及其对于预后的影响.方法 选取在该院就诊的剖宫产瘢痕异位妊娠患者198例作为研究对象,其中98例使用输卵管内注射MTX 30 mg介入治疗方法者作为介入治疗组,另100例患者使用常规保守治疗方法(MTX肌肉注射配合米非司酮口服,最后行清宫术)作为对照组;收集两组患者基本信息、治疗后疗效情况,近期和较远期预后信息,完成疗效比较与预后评价.结果 介入治疗组治疗成功率达97.93％,明显高于对照组的90.85％,差异有统计学意义(P＜0.05);介入治疗组住院时间和病灶消失时间平均值分别为(10.67 ± 2.36)d和(51.66 ± 8.76)d,低于对照组的(16.71 ± 2.86)d和(69.16 ± 8.49)d,介入治疗组住院时间及病灶消失时间也明显低于对照组,差异均有统计学意义(P＜0.05).相关预后分析结果提示,两组患者近期预后差异无统计学意义(P＞0.05);两组患者β-人绒毛膜促性腺激素转阴时间及月经恢复时间比较,差异均无统计学意义(P＞0.05);介入治疗组复发率为2.04％,低于对照组的4.00％,差异有统计学意义(P＜0.05),介入治疗组预后受孕率为10.20％,高于对照组的4.00％,差异有统计学意义(P＜0.05).结论 输卵管内注射MTX介入治疗剖宫产瘢痕妊娠成功率高,远期预后优良,值得临床推广应用.
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