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目的分析宫腔镜电切术联合甲氨蝶呤化疗治疗剖宫产切口疤痕妊娠的疗效及安全性。方法选取郸城县妇幼保健院2013年4月—2016年6月收治的60例剖宫产切口疤痕妊娠患者,根据治疗方案不同分为观察组(30例)和对照组(30例),观察组给予宫腔镜电切术联合甲氨蝶呤化疗,对照组给予甲氨蝶呤化疗后负压吸引清宫术治疗,比较两组成功率、手术一般情况(术中失血量、手术用时)、血清β-HCG恢复正常时间、月经恢复时间及并发症发生率。结果两组成功率比较,差异无统计学意义(χ~2=0.268,P>0.05);与对照组相比,观察组手术一般情况较佳,差异具有统计学意义(P<0.05);与对照组相比,观察组血清β-HCG恢复正常时间、月经恢复时间显著降低,差异具有统计学意义(P<0.05);观察组并发症发生率低于对照组(20.00%),差异具有统计学意义(χ~2=4.630,P<0.05)。结论剖宫产切口疤痕妊娠采用宫腔镜电切术联合甲氨蝶呤化疗治疗,可降低术中出血量,减少手术用时,安全可靠,推广价值较高。
Objective To analyze the curative effect and safety of hysteroscopic electrotomy combined with methotrexate chemotherapy in the treatment of cesarean section scar pregnancy. Methods 60 cases of cesarean scar incision pregnancy treated in Dancheng Maternal and Child Health Hospital from April 2013 to June 2016 were selected and divided into observation group (30 cases) and control group (30 cases) according to different treatment regimens. Group were given hysteroscopic electrotomy combined with methotrexate chemotherapy, the control group was given methotrexate chemotherapy after vacuum suction curettage, the success rate of the two groups, the general operation (intraoperative blood loss, surgery time), serum β-HCG recovery time, menstruation recovery time and the incidence of complications. Results There was no significant difference in the success rate between the two groups (χ ~ 2 = 0.268, P> 0.05). Compared with the control group, the observation group had better general operation, the difference was statistically significant (P <0.05) (P <0.05). The incidence of complications in the observation group was lower than that in the control group (20.00%), the difference was statistically significant Significance (χ ~ 2 = 4.630, P <0.05). Conclusion Cesarean section incision scar pregnancy using hysteroscopic electrotomy combined with methotrexate chemotherapy can reduce the amount of intraoperative bleeding, reduce the time of surgery, safe, reliable, and high value for promotion.