国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2011年
8期
900-902
,共3页
剖宫产术后疤痕%异位妊娠%甲氨蝶呤%宫腔镜
剖宮產術後疤痕%異位妊娠%甲氨蝶呤%宮腔鏡
부궁산술후파흔%이위임신%갑안접령%궁강경
Scar after cesarean section%Pregnancy%Methotrexate%Hysteroscopy
目的 探讨甲氨喋呤联合宫腔镜治疗剖宫产疤痕部位妊娠(CSP)的可行性及疗效.方法 选取CSP患者43例,随机分成3组.研究组(18例)是在B超引导下经阴道妊娠囊局部穿刺注射MTX 50 mg,血β-HCG下降至100 mIU/ml以下后行宫腔镜电切清除病灶;对照组一(12例)是在B超引导下经阴道妊娠囊局部注入MTX 50 mg,血β-HCG下降至l00mIU/ml以下后在B超监测下行清宫术;对照组二(13例)是予MTX 50mg臀部肌注,每日1次,共2次,血β-HCG下降至100 mIU/ml以下后在B超监测下行清宫术;观察术中失血量、平均住院时间、血β-HCG消退时间、医疗费用.结果 研究组术中失血量、平均住院时间、血β-HCG消退时间、医疗费用分别为(60±10)ml、(7±1)天、(14±2)天、(1500±100)元;对照组一术中失血量、平均住院时间、血β-HCG消退时间、医疗费用分别为(200±20)ml、(8±1)天、(16±2)天、(2000±200)元;对照组二术中失血量、平均住院时间、血β-HCG消退时间、医疗费用分别为(250±20)ml、(14±2)天、(28±2)天、(2500±200)元;研究组与两个对照组比较差异均有显著性(P＜0.05).结论 甲氨喋呤联合宫腔镜治疗CSP具有安全有效、住院时间短、医疗费用低等优点.
目的 探討甲氨喋呤聯閤宮腔鏡治療剖宮產疤痕部位妊娠(CSP)的可行性及療效.方法 選取CSP患者43例,隨機分成3組.研究組(18例)是在B超引導下經陰道妊娠囊跼部穿刺註射MTX 50 mg,血β-HCG下降至100 mIU/ml以下後行宮腔鏡電切清除病竈;對照組一(12例)是在B超引導下經陰道妊娠囊跼部註入MTX 50 mg,血β-HCG下降至l00mIU/ml以下後在B超鑑測下行清宮術;對照組二(13例)是予MTX 50mg臀部肌註,每日1次,共2次,血β-HCG下降至100 mIU/ml以下後在B超鑑測下行清宮術;觀察術中失血量、平均住院時間、血β-HCG消退時間、醫療費用.結果 研究組術中失血量、平均住院時間、血β-HCG消退時間、醫療費用分彆為(60±10)ml、(7±1)天、(14±2)天、(1500±100)元;對照組一術中失血量、平均住院時間、血β-HCG消退時間、醫療費用分彆為(200±20)ml、(8±1)天、(16±2)天、(2000±200)元;對照組二術中失血量、平均住院時間、血β-HCG消退時間、醫療費用分彆為(250±20)ml、(14±2)天、(28±2)天、(2500±200)元;研究組與兩箇對照組比較差異均有顯著性(P＜0.05).結論 甲氨喋呤聯閤宮腔鏡治療CSP具有安全有效、住院時間短、醫療費用低等優點.
목적 탐토갑안첩령연합궁강경치료부궁산파흔부위임신(CSP)적가행성급료효.방법 선취CSP환자43례,수궤분성3조.연구조(18례)시재B초인도하경음도임신낭국부천자주사MTX 50 mg,혈β-HCG하강지100 mIU/ml이하후행궁강경전절청제병조;대조조일(12례)시재B초인도하경음도임신낭국부주입MTX 50 mg,혈β-HCG하강지l00mIU/ml이하후재B초감측하행청궁술;대조조이(13례)시여MTX 50mg둔부기주,매일1차,공2차,혈β-HCG하강지100 mIU/ml이하후재B초감측하행청궁술;관찰술중실혈량、평균주원시간、혈β-HCG소퇴시간、의료비용.결과 연구조술중실혈량、평균주원시간、혈β-HCG소퇴시간、의료비용분별위(60±10)ml、(7±1)천、(14±2)천、(1500±100)원;대조조일술중실혈량、평균주원시간、혈β-HCG소퇴시간、의료비용분별위(200±20)ml、(8±1)천、(16±2)천、(2000±200)원;대조조이술중실혈량、평균주원시간、혈β-HCG소퇴시간、의료비용분별위(250±20)ml、(14±2)천、(28±2)천、(2500±200)원;연구조여량개대조조비교차이균유현저성(P＜0.05).결론 갑안첩령연합궁강경치료CSP구유안전유효、주원시간단、의료비용저등우점.
Objective To investigate the feasibility and clinical efficacy of the combination of lacalmethotrexate with Hysteroscopy in the treatmertt of CSP. Methods 43 patients diagnosed with CSP were divided into three groups: the study group(n=18) received an intra - amniotic methotrexate injection or methotrexate injection into the ectopic gestational mass and surrounding myometrium under ultrasound - guide. When the level of HCG in serum gradually dropped to less than 100 mIU/ml, the patients underwent operative hysteroscopy to remove the ectopic geasational tissue. the NO.1 control group(n=12)were uterined curettage under ultrasound - guided aftet same lacalmethotrexate, the NO.2 control group (n=13) were uterined curettage under ultrasound - guided aftet methotrexate injection. Results All the cases in study group were preformed success more fully to avoid hysterectomy than control group and preserve the reproductive capacity. Blood loss was more limited, the patients were recovered more quicklly,and the prognosis was satisfactory(P＜ 0.05). Conclusion Methotrexate combined with hysteroscopy to cure CSP has the advantages of safety, efficacy, short hospital stay, and low cost.
