摘要
目的 分析经阴道超声介入引导注射甲氨蝶呤治疗剖宫产瘢痕妊娠的临床效果。方法 选择2020年6月—2021年6月在湖州市妇幼保健院就诊的82例剖宫产瘢痕妊娠患者,采用随机数字表法分为两组,每组各41例患者。对照组采用肌内注射甲氨蝶呤联合B超下清宫术治疗,观察组采用经阴道超声介入引导注射甲氨蝶呤联合B超下清宫术治疗。对比两组患者临床指标,治疗前和治疗后搏动指数(PI)、血管指数(VI)、最大血流速度(Vmax),并对比两组患者不良反应发生情况。结果 观察组血清人绒毛膜促性腺激素(hCG)水平恢复至正常的时间、住院时间、子宫瘢痕处宫壁直径、月经恢复时间、追加甲氨蝶呤次数分别为(21.51±3.27)d、(15.14±3.23)d、(3.68±0.55)cm、(42.98±5.35)d、(2.75±0.76)次;对照组血清hCG水平恢复至正常的时间、住院时间、子宫瘢痕处宫壁直径、月经恢复时间、追加甲氨蝶呤次数分别为(25.41±3.42)d、(19.33±3.25)d、(3.53±0.66)cm、(52.68±6.35)d、(3.68±0.74)次。观察组血清hCG水平恢复至正常的时间、住院时间、月经恢复时间均短于对照组,子宫瘢痕处宫壁直径大于对照组,追加甲氨蝶呤次数少于对照组,差异均有统计学意义(均P<0.05)。治疗前,两组患者VI、PI、Vmax比较差异均无统计学意义(均P>0.05);治疗后,观察组VI、PI、Vmax均低于对照组,差异均有统计学意义(均P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论 经阴道超声介入引导注射甲氨蝶呤治疗剖宫产瘢痕妊娠的临床效果较好,可缩短患者血清hCG水平恢复至正常的时间、月经恢复时间、住院时间,减少甲氨蝶呤追加次数,降低患者血流指数,安全性高。
Objective To analyze the clinical effect of transvaginal ultrasound-guided injection of methotrexate in treatment of cesarean section scar pregnancy.Methods A total of 82 patients with cesarean section scar pregnancy who were treated in Maternal and Child Health Hospital of Huzhou City from June 2020 to June 2021 were selected and divided into two groups using random number table method,41 patients in each group.The patients in control group were treated with intramuscular injection of methotrexate combined with B-ultrasound uterine evacuation,and the patients in observation group were treated with transvaginal ultrasound-guided injection of methotrexate combined with B-ultrasound uterine evacuation.The clinical indicators,pulsation index(PI),vascular index(VI),and maximum blood flow velocity(Vmax) levels before and after treatment,the occurrence of adverse reactions in the two groups were compared.Results The time of serum human chorionic gonadotropin(hCG) level retuen to normal,hospitalization time,diameter of uterine scar wall,recovery time of menstruation,the times of additional methotrexate in observation group were(21.51±3.27) days,(15.14±3.23) days,(3.68±0.55)cm,(42.98±5.35) days,and(2.75±0.76),respectively;the time of hCG level retuen to normal,hospitalization time,diameter of uterine scar wall,recovery time of menstruation,the times of additional methotrexate in control group were(25.41±3.42) days,(19.33±3.25) days,(3.53±0.66)cm,(52.68±6.35) days,and(3.68±0.74),respectively.The time of hCG level retuen to normal,hospitalization time,and recovery time of menstruation in observation group were shorter than those in control group,diameter of uterine scar wall was larger than that in control group,the times of additional methotrexate was less than that in control group(all P<0.05).Before treatment,there was no statistically significant difference in VI,PI,and Vmax between the two groups(all P<0.05);after treatment,VI,PI,and Vmax in observation group were lower than those in control group,there were statistically significant differences(all P<0.05).The incidence rate of adverse reactions in observation group was statistically significantly lower than that in control group(P<0.05).Conclusion The clinical effect of transvaginal ultrasound-guided injection of methotrexate in treatment of cesarean section scar pregnancy is good,and it can shorten the time of hCG level retuen to normal,recovery time of menstruation,and hospitalization time,and reduce the times of additional methotrexate and blood flow indexes,and the safety is high.
作者
徐亚芬
刘明松
蔡婷婷
任月芳
XU Ya-fen;LIU Ming-song;CAI Ting-ting;REN Yue-fang(Special Inspection Section,Maternal and Child Health Hospital of Huzhou City,Huzhou,Zhejiang 313000,China)
出处
《中国妇幼保健》
CAS
2023年第21期4272-4275,共4页
Maternal and Child Health Care of China
基金
浙江省卫生健康科技计划项目(2021RC127)。
关键词
剖宫产瘢痕妊娠
甲氨蝶呤
经阴道超声
效果
Cesarean section scar pregnancy
Methotrexate
Transvaginal ultrasound
Effect
