剖宫产瘢痕处妊娠60例不同治疗方法临床研究

摘要

目的:比较两种剖宫产瘢痕处妊娠治疗方案的临床效果.方法:回顾性分析60例剖宫产瘢痕处妊娠患者的临床资料,根据其入院初始治疗方案的不同,分别行米非司酮+甲氨喋呤(M TX)组(A组,28例)、子宫动脉灌注M TX+栓塞组(B组,32例).结果:米非司酮+ M TX组患者的一次治疗成功率为71.4%(20/28),子宫动脉灌注M T X+ 栓塞组患者的一次治疗成功率为96.9%(31/32),两组患者相比较,差异有统计学意义(χ2=7.584,P=0.009).米非司酮+ M TX组患者术中出血量、术后β-hCG恢复正常时间、住院时间与子宫动脉灌注M T X+栓塞组患者相比,明显增多,差异有统计学意义(P<0.05).结论:子宫动脉灌注M TX+栓塞治疗CSP的方案更加有效、经济和安全.%Objective:To investigate the efficiency of two methods in treating patients with cesarean scar preg-nancy(CSP).Methods:60 CSP patients who divided into two groups according to method of the treatment were retrospectively analyzed,28 patients were treated with uterine curettage after M TX and mifepristone treatment, while the other 32 patients under went Uterine arterial infusion MTX and embolization therapy combined with uter-ine curettage.Results:The first treatment success rate of MTX and mifepristone treatment was 71.4%(20/28),The first treatment success rate of Uterine arterial infusion MTX and embolization therapy was 96.9%(31/32),the difference was statistically significant(χ2=7.584,P=0.009).the hemorrhage,time for HCG recovery,duration of hospital stays of patients treated with MTX and mifepristone treatment were significantly increased compare with pa-tients under went Uterine arterial infusion MTX and embolization therapy,the difference was statistically significant (P<0.05).Conclusion:Uterine arterial infusion MTX and embolization therapy could be an effective,economic and safe treatment for Cesarean scar pregnancy.