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目的:分析两种药物联合治疗剖宫产疤痕妊娠的临床疗效。方法:入选2007年4月~2012年12月在该院住院治疗的剖宫产疤痕妊娠患者84例,根据药物治疗的适应证和患者的意愿筛选74例进行药物保守治疗。剖宫产疤痕妊娠患者首先肌注天花粉,1周后在超声引导下囊内抽吸并注射甲氨蝶呤(MTX)。观察两种药物治疗的临床效果及不良反应。结果:64例患者血清β-人绒毛膜促性腺激素(β-HCG)在药物治疗1月后下降到正常水平,10例患者血清β-HCG在给予药物后短暂下降,之后无改变甚至上升。剖宫产疤痕妊娠患者治愈率达86.5%。结论:天花粉联合甲氨蝶呤治疗剖宫产疤痕妊娠临床效果显著、起效快、不良反应小。
Objective: To analyze the clinical efficacy of two drugs in the treatment of cesarean scar pregnancy. Methods: Eighty-four patients with cesarean scar pregnancy treated in our hospital from April 2007 to December 2012 were enrolled. According to the indication of drug treatment and the patients’ wishes, 74 patients were screened for conservative treatment. Patients with cesarean scar pregnancy were initially intramuscularly administered with TCS, and 1 week later ultrasound-guided intracapsular aspiration and methotrexate (MTX) injection were performed. To observe the clinical effects and adverse reactions of two kinds of drug treatment. Results: Serum β-HCG in 64 patients decreased to normal levels after 1 month of treatment. The serum β-HCG of 10 patients decreased transiently after administration of the drug, but did not change or even increased afterwards. Cesarean scar pregnancy cure rate of 86.5%. Conclusion: TC combined with methotrexate treatment of cesarean scar pregnancy clinically significant effect, rapid onset, adverse reactions.