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目的:观察分析剖宫产瘢痕妊娠患者采用不同治疗方法治疗的临床效果。方法:选取我院80例剖宫产瘢痕妊娠患者按照随机分配法分为研究组(采用甲氨蝶呤(MTX)联合孕囊穿刺治疗)和对照组(单独采用药物治疗),将两组患者治疗效果、治疗前后血β-人绒毛膜促性腺激素(β-HCG)水平变化情况、手术相关指标等情况进行对比分析。结果:研究组治愈39例,失败1例,对照组治愈30例,失败10例,研究组治愈率(97.5%)明显高于对照组(75%),两组差异对比存在统计学意义(P<0.05)。治疗前两组患者血β-HCG水平并没有很大差异(P>0.05),但是研究组患者治疗后血β-HCG水平显著低于对照组(P<0.05)。研究组患者血β-HCG水平恢复到正常水平需要的时间(24.1±5.5)d明显短于对照组(47.9±8.1)d,两组差异对比存在统计学意义(P<0.05)。研究组患者转经时间、出血量以及住院时间等相对于对照组均明显缩短(P<0.05)。结论:剖宫产瘢痕妊娠患者采用MTX联合孕囊穿刺治疗的临床效果显著,治疗优势显著优于单独的药物治疗,可有效缩短血β-HCG恢复到正常水平的时间、转经时间,减少出血量,帮助患者尽快出院,在临床上具有较高的推广应用价值。
Objective: To observe and analyze the clinical effect of different treatment methods in cesarean scar pregnancy patients. Methods: Eighty patients with cesarean scar pregnancy in our hospital were randomly divided into study group (methotrexate (MTX) combined with gestational sac puncture) and control group (treated with drug alone). Patients in both groups Treatment effect, changes of blood β-human chorionic gonadotropin (β-HCG) level before and after treatment, operation-related indicators and so on were compared and analyzed. Results: In the study group, 39 cases were cured and 1 failed. The control group was cured in 30 cases and failed in 10 cases. The cure rate in the study group was significantly higher than that in the control group (97.5% vs 75%) (P <0.05). There was no significant difference in serum β-HCG levels between the two groups before treatment (P> 0.05), but the level of β-HCG in the study group was significantly lower than that in the control group (P <0.05). The time required for the return of β-HCG to normal level in the study group was significantly shorter than that in the control group (24.1 ± 5.5) d (47.9 ± 8.1) days, with significant difference between the two groups (P <0.05). The study group, the transit time, bleeding and hospitalization time were significantly shorter compared with the control group (P <0.05). CONCLUSIONS: The clinical effect of MTX combined with gestational sac puncture in patients with cesarean scar pregnancy is significant. The treatment advantage is significantly better than that of drug alone, which can effectively shorten the recovery time of blood β-HCG to normal level, reduce the hemorrhage Volume, to help patients discharged as soon as possible, has a higher clinical application value.