CAJ | 학술논문

目的探讨中西医结合治疗剖宫产瘢痕妊娠的临床疗效。方法对2010年5月至2012年12月在湖南省妇幼保健院妇科住院治疗的未破裂型剖宫产瘢痕妊娠患者进行回顾性分析，将其归纳为对照组和观察组，对照组24例，给予单纯M T X治疗后宫腔镜下清宫，观察组101例，给予中药结合M T X治疗后再行宫腔镜下清宫。对比分析两组患者治疗成功率、血清人绒毛膜促性腺激素（β‐HCG）和子宫不均质回声体积平均下降速度及不良反应发生情况。结果 ①观察组首次清宫成功率明显高于对照组，差异有统计学意义（ P ＜0．05）；②观察组清宫过程中出现阴道大出血需要中转开腹手术或需用水囊压迫止血比率低于对照组，但其差异无统计学意义（ P ＞0．05）；③观察组β‐HCG的平均下降速度明显快于对照组，差异有统计学意义（ P ＜0．05）；④观察组子宫下段不均质回声体积的平均下降速度与对照组比较无统计学差异；⑤观察组不良反应发生率与对照组比较无统计学差异。结论中西医结合治疗剖宫产瘢痕妊娠成功率、β‐HCG平均下降速度均优于单纯西医治疗法，值得临床推广。
목적 탐토중서의결합치료부궁산반흔임신적림상료효。방법 대2010년5월지2012년12월재호남성부유보건원부과주원치료적미파렬형부궁산반흔임신환자진행회고성분석，장기귀납위대조조화관찰조，대조조24례，급여단순M T X치료후궁강경하청궁，관찰조101례，급여중약결합M T X치료후재행궁강경하청궁。대비분석량조환자치료성공솔、혈청인융모막촉성선격소（β‐HCG）화자궁불균질회성체적평균하강속도급불량반응발생정황。결과 ①관찰조수차청궁성공솔명현고우대조조，차이유통계학의의（ P ＜0．05）；②관찰조청궁과정중출현음도대출혈수요중전개복수술혹수용수낭압박지혈비솔저우대조조，단기차이무통계학의의（ P ＞0．05）；③관찰조β‐HCG적평균하강속도명현쾌우대조조，차이유통계학의의（ P ＜0．05）；④관찰조자궁하단불균질회성체적적평균하강속도여대조조비교무통계학차이；⑤관찰조불량반응발생솔여대조조비교무통계학차이。결론 중서의결합치료부궁산반흔임신성공솔、β‐HCG평균하강속도균우우단순서의치요법，치득림상추엄。
Objective]To explore clinical efficacy of combined treatment of traditional Chinese medicine and Western medicine for the treatment of cesarean scar pregnancy .[Methods]Clinical data of patients with unruptured cesarean scar pregnancy hospitalized in maternal and child health hospital of Hunan province from May 2010 to Dec . 2012 were analyzed retrospectively and divided into control group and observation group .The control group( n=24) underwent clearing the pericardium under hysteroscopy after simple MTX treatment .The observation group( n =101) underwent clearing the pericardium under hysteroscopy after traditional Chinese medicine combined with MTX treatment .The treatment success rate ,average decline speed of serum human chorionic gonadotropin(β‐HCG) and u‐terine heterogeneous echo volume and adverse reaction of two groups were compared and analyzed .[Results]The first success rate of clearing the pericardium in observation group was obviously higher than that in control group ,and there was significant difference( P<0 .05) .The rates of laparotomy or water sac compression for vaginal hemorrhea in observation during the operation were lower than those in control group ,and there was significant difference( P>0 .05) .The average decline speed ofβ‐HCG in observation group was obviously faster than that in control group( P<0 .05) .There was no significant difference in average decline speed of uterine heterogeneous echo volume between two groups( P>0 .05) .There was no significant difference in the incidence of adverse reaction between two groups( P>0 .05) .[Conclusion] The success rate and the average decline speed ofβ‐HCG in observation group receiving the combined treatment of traditional Chinese medicine and Western medicine are better than simple Western medicine treatment .Therefore ,the combined treatment of traditional Chinese and Western medicine is worthy to be popular‐ized .