CAJ | 학술논문

目的综合评价剖宫产瘢痕妊娠(CSP)治疗方法的疗效和卫生经济学效益.方法全面检索美国国家医学图书馆生物技术信息检索系统(PubMed)、维普、万方等中英文数据库,搜集CSP治疗的相关文献,并按照一定的纳入和排除标准进行文献筛选.提取纳入文献的手术时间、术中出血量、子宫切除率、住院时间、医疗费用、血β-人绒毛膜促性腺激素(HCG)转阴时间等观察指标,计算加权均数及组合标准差.结果在CSP治疗方法中,甲氨蝶呤肌内或静脉注射后清宫术的手术时间相对较短；子宫动脉栓塞后清宫术的术中出血量、子宫切除率以及住院天数均相对较小；甲氨蝶呤局部注射后清宫术的医疗费用相对较低；甲氨蝶呤肌注或子宫动脉栓塞后宫、腹腔镜手术的术后血清β-HCG转阴时间较短.结论子宫动脉栓塞后清宫术治疗CSP较其他方法占有较大优势.
목적 종합평개부궁산반흔임신(CSP)치료방법적료효화위생경제학효익.방법 전면검색미국국가의학도서관생물기술신식검색계통(PubMed)、유보、만방등중영문수거고,수집CSP치료적상관문헌,병안조일정적납입화배제표준진행문헌사선.제취납입문헌적수술시간、술중출혈량、자궁절제솔、주원시간、의료비용、혈β-인융모막촉성선격소(HCG)전음시간등관찰지표,계산가권균수급조합표준차.결과 재CSP치료방법중,갑안접령기내혹정맥주사후청궁술적수술시간상대교단；자궁동맥전새후청궁술적술중출혈량、자궁절제솔이급주원천수균상대교소；갑안접령국부주사후청궁술적의료비용상대교저；갑안접령기주혹자궁동맥전새후궁、복강경수술적술후혈청β-HCG전음시간교단.결론 자궁동맥전새후청궁술치료CSP교기타방법점유교대우세.
Objective To evaluate the efficacies and medicoeconomic efficiency of therapeutic method for cesarean scar pregnancy (CSP).Methods The pertinent literatures on the treatment of CSP were collected and screened by retrieving some Chinese and English databases,such as PubMed,VIP and Wanfang Data.The weighting means and polled standard deviations of operative duration, operative hemorrhage volume,hysterectomy rate,length of stay,medical fees and the time of serum level of betahuman chorionic gonadotropin (β-HCG) returning to normal were reckoned.Results Among different therapeutic methods of CSP,curettage duration was shortest in the patients with methotrexate ( MTX ) injection; operative hemorrhage volume,hysterectomy rate and length of stay were smallest in those with uterine artery embolization; medical fees was least in those with local MTX injection; the time of serum β-HCG level returning to normal was shortest in those with hysteroscopic and/or laparoscopic operation after MTX injection or uterine artery embolization.Conclusion Curettage after uterine artery embolization offers multiple advantages over therapeutic methods in the treatment of CSP.