摘要
目的 分析超声下孕囊内注射甲氨蝶呤治疗子宫瘢痕妊娠(CSP)临床疗效影响因素。方法 回顾性选取邯郸市中心医院收治的84例均接受超声下孕囊内注射甲氨蝶呤治疗的CSP患者,根据治疗效果的不同分为疗效良好组和疗效一般组,采用单因素及多因素Logistic回归分析两组患者临床疗效的相关影响因素。结果 84例CSP患者应用超声下孕囊内注射甲氨蝶呤治疗后,81例患者治疗有效,其中疗效良好组患者有53例,疗效一般组患者28例。单因素分析结果提示,剖宫产次数、瘢痕厚度、CSP类型、孕囊体积、术前血人绒毛膜促性腺激素(β-HCG)水平、受孕周数、超声下CSP与肌层分界情况均是影响超声下孕囊内注射甲氨蝶呤治疗CSP临床疗效的相关因素(均P<0.05)。进一步多因素Logistic回归分析结果提示,CSP类型为外生型、孕囊体积≥10 cm^(3)、受孕周数≥9周、超声下CSP与肌层分界不清晰均是影响超声下孕囊内注射甲氨蝶呤治疗CSP临床疗效的独立危险因素(均P<0.05)。结论 外生型CSP、孕囊体积≥10cm^(3)、受孕周数≥9周、超声下CSP与肌层分界不清晰均是影响超声下孕囊内注射甲氨蝶呤治疗CSP临床疗效的独立危险因素,临床上应尽早制定相应的针对性干预方案以避免或减少上述因素对临床疗效造成的不良影响。
Objective To analyze the influencing factors of clinical efficacy of ultrasonic intrapacial injection of methotrexate(MTX)in the treatment of uterine scar pregnancy(CSP).Methods Eighty-four CSP patients treated with intravascular injection of methotrexate under ultrasound in Handan Central Hospital were retrospectively selected and divided into good efficacy group and average efficacy group according to different therapeutic effects.Univariate and multivariate Logistic regression were used to analyze the related influencing factors of clinical efficacy in the two groups.Results Eightyfour patients with CSP were treated with methotrexate injection under ultrasound,81 patients were effective,including 53 patients with good curative effect group,28 patients with general curative effect group.Univariate analysis showed that the number of cesarean section,scar thickness,CSP type,gestational sac volume,preoperative bloodβ-HCG level,gestational weeks,and the boundary between CSP and muscle layer under ultrasound were all related factors affecting the clinical efficacy of gestational sac injection of methotrexate under ultrasound for CSP(all P<0.05).Further multivariate Logistic regression analysis showed that the type of exogenous CSP,gestational sac volume≥10 cm^(3),gestational weeks≥9 weeks,and unclear boundary between CSP and myometrium under ultrasound were independent risk factors affecting the clinical efficacy of methotrexate injection in the treatment of CSP under ultrasound(all P<0.05).Conclusion exogenous type CSP conception,pregnancy sac volume≥10 cm^(3),gestational weeks≥9 weeks,the ultrasound is no clear boundary between CSP and muscle layer are under the influence of ultrasonic gestation sac injection of methotrexate in the treatment of CSP clinical curative effect of the independent risk factors,clinical should formulate corresponding targeted intervention plan as early as possible in order to avoid or reduce the adverse impact of these factors on the clinical curative effect.
作者
赵红
田芬
张力
吕君楠
邢凯
申志华
尹素芳
周虎
ZHAO Hong;TIAN Fen;ZHANG Li;LYU Junnan;XING Kai;SHEN Zhihua;YIN Sufang;ZHOU Hu(Handan Central Hospital,Handan,Hebei 056001,China;General Hospital of Handan Mining Group Co.,Ltd.,Handan,Hebei 056001,China)
出处
《中国优生与遗传杂志》
2023年第4期776-780,共5页
Chinese Journal of Birth Health & Heredity
基金
邯郸市科学技术研究与发展计划项目(19422083014ZC)。
关键词
子宫瘢痕妊娠
超声引导
孕囊内注药
清宫术
影响因素
cesarean scar pregnancy
ultrasonic guidance
injecting drugs into the pregnancy sac
uterine evacuation
affecting factors
