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目的:探讨甲氨蝶呤灌注及子宫动脉栓塞联合清宫术对子宫瘢痕妊娠患者效果及对血清孕酮和β-人绒毛膜促性腺激素(β-HCG)水平的影响。方法:子宫瘢痕妊娠患者78例随机分为观察组39例与对照组39例。对照组采用开腹行病灶清除术联合口服米非司酮治疗,观察组采用甲氨蝶呤灌注+子宫动脉栓塞联合清宫术治疗。比较两组患者术中出血量、血清HCG恢复正常时间、月经恢复时间、超声瘢痕处包块消失时间,治疗前和治疗7 d后血清孕酮和β-HCG水平变化,并发症发生情况。结果:观察组术中出血量少于对照组(P<0.05);观察组血清β-HCG恢复正常时间、月经恢复时间均明显优于对照组(P<0.05);两组血清孕酮和β-HCG水平治疗后明显下降(P<0.05);观察组血清孕酮和β-HCG水平治疗后低于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05)。结论:甲氨蝶呤灌注及子宫动脉栓塞联合清宫术对子宫瘢痕妊娠患者效果明显,可明显降低患者血清孕酮和β-HCG水平,具有重要研究意义。
Objective: To investigate the effect of methotrexate perfusion and uterine arterial embolization combined with curettage on uterine scar pregnancy patients and serum progesterone and β-human chorionic gonadotropin (β-HCG) levels. Methods: 78 cases of uterine scar pregnancy were randomly divided into observation group 39 cases and control group 39 cases. The control group was treated with laparoscopic debridement combined with oral mifepristone. The observation group was treated with methotrexate perfusion and uterine artery embolization combined with curettage. The blood loss, serum HCG recovery time, menstruation recovery time, disappearance time of ultrasonic scar, serum progesterone and β-HCG levels before and 7 days after treatment were compared between the two groups. Results: The blood loss in the observation group was less than that in the control group (P <0.05). Serum β-HCG recovery time and menstruation recovery time in the observation group were significantly better than those in the control group (P <0.05) (P <0.05). The levels of serum progesterone and β-HCG in the observation group were lower than those in the control group (P <0.05). The incidence of complications in the observation group was lower than that in the control group (P <0.05) . Conclusion: Methotrexate perfusion and uterine artery embolization combined with curettage in patients with uterine scar pregnancy effect is obvious, can significantly reduce the serum progesterone and β-HCG levels, has important research significance.