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山东大学学报(医学版) ›› 2014, Vol. 52 ›› Issue (1): 75-79.doi: 10.6040/j.issn.1671-7554.0.2013.651

• 临床医学 • 上一篇    下一篇

102例剖宫产术后子宫瘢痕处妊娠治疗效果评价

赵真,董白桦,苏士利   

  1. 山东大学齐鲁医院计划生育科, 济南 250012
  • 收稿日期:2013-10-30 出版日期:2014-01-10 发布日期:2014-01-10
  • 通讯作者: 董白桦, E-mail:usera9597@163.com

Treatment of 102 cases with caesarean scar pregnancy

ZHAO Zhen, DONG Bai-hua, SU Shi-li   

  1. Department of Gynecology and Obstetrics, Qilu Hospital of Shandong University, Jinan 250012, China
  • Received:2013-10-30 Online:2014-01-10 Published:2014-01-10

摘要:

目的  评价剖宫产术后子宫瘢痕处妊娠的处理方式。方法  回顾分析2006年1月至2012年2月山东大学齐鲁医院确诊的剖宫产术后子宫瘢痕处妊娠患者102例。分为甲氨蝶呤(MTX)肌内+宫腔注射组(A组)、MTX肌内+宫腔注射+超声引导下清宫组(B组)和子宫动脉灌注化疗栓塞+超声引导吸宫组(C组)。结果  A、B、C 3组患者血绒毛膜促性腺激素(β-hCG) 恢复至正常时间、瘢痕部位包块消失时间、阴道流血时间、住院时间、住院费用相比较差异有统计学意义(P<0.05)。A、B、C 3组患者治疗成功率分别为92.86%、88.52%、84.62%(P>0.05)。结论   3组方法均可达到较高的治愈率,但MTX肌内+宫腔注射方法简单,花费少,避免侵入性操作。

关键词: 剖宫产术, 清宫术, 瘢痕妊娠, 甲氨蝶呤, 子宫动脉栓塞术

Abstract:

Objective  To evaluate the treatment of caesarean scar pregnancy. Methods  Data of 102 patients with caesarean scar pregnancy treated during Jan. 2006 to Feb. 2012 were retrospectively reviewed with clinical cohort study. The patients were divided into 3 groups, including muscle and intrauterine cavity injection of methotrexate (MTX, Group A), MTX therapy followed by ultrasound-guided suction curettage (Group B) and uterine arteries embolization followed by low vacuum aspiration (Group C). Results  The mean resolution time of serum β-hCG, time taken for CSP mass to disappear, time of vaginal bleeding, hospital stay and costs were statistically different in the three groups (P<0.05). The success rate for Group A, B and C were 92.86%, 88.52% and 84.62%, respectively, with no statistically significant difference (P>0.05). Conclusion  All three therapies yield high success rate, while muscle and intrauterine cavity injection of methotrexate is effective, cheap and non-invasive.

Key words: Suction curettage, Caesarean delivery, Ectopic pregnancy, Methotrexate, Uterine arteries embolization

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