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经阴道超声介入配合药物治疗剖宫产术后瘢痕妊娠(1)
http://www.100md.com 2020年4月15日 《中国现代医生》 202011
     [摘要] 目的 探讨经阴道超声引导介入配合药物治疗剖宫产术后瘢痕妊娠的价值。 方法 选择2016年1月~2019年7月葫芦岛市中心医院收治的瘢痕妊娠患者120例作为研究对象,按照随机数字表法分为观察组(n=60,阴道超声引导甲氨蝶呤注射)和对照组(n=60,甲氨蝶呤肌注)。随访至治疗后7 d;比较两组的治愈率、清宫出血情况、甲氨蝶呤追加次数、血β-HCG恢复时间、包块消失时间以及血清INH-A、VEGF、PAPP-A水平和不良反应发生率。结果 观察组治愈率(93.33%)高于对照组(71.67%),差异有统计学意义(P<0.05);观察组清宫出血量、甲氨蝶呤追加次数少于对照组,观察组血β-HCG复常时间、包块消失时间短于对照组,差异均有统计学意义(P<0.05);治疗后3 d、7 d两组INH-A、VEGF、PAPP-A均降低,且观察组低于对照组,差异均有统计学意义(P<0.05);观察组不良反应率(5.00%)较对照组(25.00%)低,差异有统计学意义(P<0.05)。 结论 经阴道超声引导局部注射药物治疗剖宫产术后瘢痕妊娠能提高疗效,促进恢复,减少不良反应。

    [关键词] 剖宫产;瘢痕妊娠;阴道超声介入治疗;甲氨蝶呤

    [中图分类号] R713.8 [文獻标识码] B [文章编号] 1673-9701(2020)11-0085-03

    Value of transvaginal ultrasound interventional therapy combined with medications in treatment of scar pregnancy due to cesarean section

    LIU Hanyue

    Department of Function, Huludao Central Hospital in Liaoning Province, Huludao 125001, China

    [Abstract] Objective To explore the value of transvaginal ultrasound interventional therapy combined with medications in treatment of scar pregnancy due to cesarean section. Methods One hundred and twenty patients with scar pregnancy treated in our hospital from January 2016 to July 2019 were selected as research subjects and were divided into the observation group (n=60, transvaginal ultrasound guided methotrexate injection) and the control group (n=60, methotrexate intramuscular injection) by the random number table. They were followed up to 7 days after treatment; the cure rate, the curettage bleeding condition, the frequency of adding methotrexate, the recovery time of blood β-HCG, the disappearance time of the mass, the levels of serum INH-A, VEGF and PAPP-A and the incidence of adverse reactions of two groups were compared. Results The cure rate in the observation group (93.33%) was higher than that in the control group (71.67%), with statistically significant difference(P<0.05); the curettage bleeding amount and the frequency of adding methotrexate in the observation group were less than those in the control group, and the recovery time of blood β-HCG and the disappearance time of the mass in the observation group were shorter than those in the control group, with statistically significant differences(P<0.05); the levels of INH-A, VEGF and PAPP-A in the two groups 3 and 7 days after treatment were decreased, which were lower in the observation group compared with those in the control group, with statistically significant differences(P<0.05); the incidence of adverse reactions in the observation group (5.00%) was lower than that in the control group(25.00%), with statistically significant difference(P<0.05). Conclusion The transvaginal ultrasound interventional therapy combined with local drug injection in treatment of scar pregnancy due to cesarean section can improve the efficacy, promote recovery and reduce adverse reactions., 百拇医药(刘寒月)
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