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目的比较子宫动脉栓塞术方案和甲氨喋呤注射治疗方案在治疗子宫瘢痕妊娠中的临床效果。方法 30例剖宫产术后子宫瘢痕妊娠患者,按治疗方法不同分为子宫动脉栓塞组22例和甲氨喋呤注射组8例,分别给予子宫动脉栓塞术和甲氨喋呤注射治疗。两组患者均行清宫术清除妊娠物。比较两组清宫术中和术后出血量、平均住院时间、血人绒毛膜促性腺激素(HCG)转阴时间及中转开腹手术情况。结果子宫动脉栓塞组出血量、住院时间明显优于甲氨喋呤注射组(P<0.05);两组患者血HCG转阴时间差异无统计学意义(P>0.05)。结论子宫动脉栓塞术治疗子宫瘢痕妊娠,可大大减少手术出血,同时也保留了患者的生育功能,是一项安全,且又无严重并发症发生的治疗方案。
Objective To compare the clinical effects of uterine artery embolization and methotrexate in the treatment of uterine scar pregnancy. Methods Thirty patients with uterine scar pregnancy after cesarean section were divided into two groups according to the different treatment: uterine arterial embolization group (n = 22) and methotrexate injection group (n = 8). Uterine arterial embolization and methotrexate injection were given respectively. Two groups of patients undergoing curettage of pregnancy. The duration of postoperative bleeding, mean length of stay, blood HCG transference time and laparotomy in two groups were compared. Results The amount of bleeding and hospital stay in patients with uterine artery embolization was significantly better than those in the methotrexate injection group (P <0.05). There was no significant difference in the HCG negative time between the two groups (P> 0.05). Conclusion Uterine artery embolization for the treatment of uterine scar pregnancy can greatly reduce the surgical bleeding, but also retains the patient’s reproductive function, is a safe, and no serious complications of treatment options.