中国计划生育和妇产科
中國計劃生育和婦產科
중국계화생육화부산과
CHINESE JOURNAL OF FAMILY PLANNING & GYNECOTOKOLOGY
2014年
2期
35-38
,共4页
子宫切口瘢痕妊娠%甲氨蝶呤%子宫动脉栓塞
子宮切口瘢痕妊娠%甲氨蝶呤%子宮動脈栓塞
자궁절구반흔임신%갑안접령%자궁동맥전새
cesarean scar pregnancy%methotrexate,uterine artery embolization
目的：观察不同方法治疗子宫切口瘢痕妊娠（cesarean scar pregnancy ，CSP）的临床效果。方法将111例CSP患者分为4组，分别采用甲氨蝶呤（ methotrexate ，MTX）全身用药、MTX局部注射、子宫动脉栓塞、手术治疗，分析监测治疗后1周血人绒毛膜促性腺激素（ human chorionic gonadotropin ，HCG）情况及转阴时间，观察治疗期间阴道出血情况及不良反应、治疗后包块超声影像变化，分析住院天数、住院费用及治愈率。结果手术治疗血HCG下降最快，住院时间、包块消失时间及HCG转阴时间最短，子宫动脉栓塞治疗次之，与MTX全身用药组比较差异均有统计学意义（ P＜0.05）；MTX局部注射对孕囊型的疗效明显优于团块型；子宫动脉栓塞治疗费用最高。结论 CSP的治疗应实行个体化治疗，MTX局部注射可作为孕囊型患者治疗的首选方法，子宫动脉栓塞治疗可作为团块型患者的首选治疗方法，对于保守治疗无效者可改行子宫病灶切除＋修复术。
目的：觀察不同方法治療子宮切口瘢痕妊娠（cesarean scar pregnancy ，CSP）的臨床效果。方法將111例CSP患者分為4組，分彆採用甲氨蝶呤（ methotrexate ，MTX）全身用藥、MTX跼部註射、子宮動脈栓塞、手術治療，分析鑑測治療後1週血人絨毛膜促性腺激素（ human chorionic gonadotropin ，HCG）情況及轉陰時間，觀察治療期間陰道齣血情況及不良反應、治療後包塊超聲影像變化，分析住院天數、住院費用及治愈率。結果手術治療血HCG下降最快，住院時間、包塊消失時間及HCG轉陰時間最短，子宮動脈栓塞治療次之，與MTX全身用藥組比較差異均有統計學意義（ P＜0.05）；MTX跼部註射對孕囊型的療效明顯優于糰塊型；子宮動脈栓塞治療費用最高。結論 CSP的治療應實行箇體化治療，MTX跼部註射可作為孕囊型患者治療的首選方法，子宮動脈栓塞治療可作為糰塊型患者的首選治療方法，對于保守治療無效者可改行子宮病竈切除＋脩複術。
목적：관찰불동방법치료자궁절구반흔임신（cesarean scar pregnancy ，CSP）적림상효과。방법장111례CSP환자분위4조，분별채용갑안접령（ methotrexate ，MTX）전신용약、MTX국부주사、자궁동맥전새、수술치료，분석감측치료후1주혈인융모막촉성선격소（ human chorionic gonadotropin ，HCG）정황급전음시간，관찰치료기간음도출혈정황급불량반응、치료후포괴초성영상변화，분석주원천수、주원비용급치유솔。결과수술치료혈HCG하강최쾌，주원시간、포괴소실시간급HCG전음시간최단，자궁동맥전새치료차지，여MTX전신용약조비교차이균유통계학의의（ P＜0.05）；MTX국부주사대잉낭형적료효명현우우단괴형；자궁동맥전새치료비용최고。결론 CSP적치료응실행개체화치료，MTX국부주사가작위잉낭형환자치료적수선방법，자궁동맥전새치료가작위단괴형환자적수선치료방법，대우보수치료무효자가개행자궁병조절제＋수복술。
Objective To observe the clinical effects of different treatments on cesarean scar pregnancy (CSP).Methods 111 patients of CSP underwent respectively treated with methotrexate (MTX)systemic treatment, MTX local treatment , uterine artery embolization ( UAE ) and surgery .The level of serum β-human chorionic gonadotrophin(HCG) a week after treatment, the time of HCG normalization were monitored.The vaginal hemorrhage and complications , the changes of ultrasonic images were observed .The hospitalization time , expenses and cure rate were analyzed .Results It was found the shortest time in serum HCG decreasing , hospitalization , CSP mass disappearance and HCG normalization of patients with surgery .Patients with UAE was the next ,significant differences were found compared to patients with MTX systemic treatment ( P<0.05) .The effect of local MTX on patients with gestational sac was superior to those with asymmetrical mass , and the cost of UAE was the highest of all . Conclusion The treatment of CSP should be individualized .MTX local treatment may be the preferred method for patients with gestational sac and UAE for patients with asymmetrical mass , while the mass resection combined with <br> uterine repair is a preferred choice for the patients with invalid conservative treatment .
