文章摘要
冀 静,左 萍,李 琛,赵 娟,王月玲.不同治疗方案治疗瘢痕部位妊娠的临床疗效分析[J].,2018,(16):3174-3178
不同治疗方案治疗瘢痕部位妊娠的临床疗效分析
Clinical Effect Analysis of Different Treatment Regimens in Treatment of Scar Site Pregnancy
投稿时间:2018-03-15  修订日期:2018-04-10
DOI:10.13241/j.cnki.pmb.2018.16.039
中文关键词: 瘢痕部位妊娠  甲氨蝶呤  人工流产术  清宫术  子宫动脉栓塞术  疗效
英文关键词: Cesarean scar pregnancy  Methotrexate  Artificial abortion  Uterine curettage  Uterine artery embolization  Curative effect
基金项目:2017年陕西省重点研发计划项目(2017SF-015)
作者单位E-mail
冀 静 西安交通大学第一附属医院妇产科 陕西 西安 710061 guwnjw@163.com 
左 萍 西安市第四医院妇产科 陕西 西安 710004  
李 琛 西安交通大学第一附属医院妇产科 陕西 西安 710061  
赵 娟 西安交通大学第一附属医院妇产科 陕西 西安 710061  
王月玲 西安交通大学第一附属医院妇产科 陕西 西安 710061  
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中文摘要:
      摘要 目的:探讨不同治疗方案治疗瘢痕部位妊娠(CSP)的临床疗效。方法:选取2010年1月至2017年9月西安交通大学第一附属医院妇产科收治的CSP患者89例,按治疗方案不同分为A、B、C三组。A组患者19例,采用药物甲氨喋呤保守治疗;B组患者30例,行B超引导下人工流产术治疗;C组患者40例,行子宫动脉栓塞术联合清宫术治疗。比较三组患者的阴道出血情况以及治疗效果。结果:C组患者治愈率最高、血清β-HCG恢复至正常时间最短、治疗后阴道出血量最少,其次为B组,最后是A组,差异具有统计学意义(P<0.05);治疗后第4d、7d,B、C两组血清β-HCG下降幅度显著高于A组(P<0.05),尤其是C组在治疗后第7d的下降幅度最大;B组患者住院时间及住院费用均低于C组及A组,但输血率高,差异具有统计学意义(P<0.05)。结论:子宫动脉栓塞术联合清宫术治疗CSP具有治愈率高、损伤小、术后恢复快等优势,在经济情况允许的情况下其临床疗效最佳。
英文摘要:
      ABSTRACT Objective: To investigate the clinical efficacy of different treatment regimens in the treatment of scar site pregnancy (CSP). Methods: A total of 89 patients with CSP, who were admitted to First Affiliated Hospital of Xi'an Jiao Tong University from January 2010 to September 2017, were selected and divided into three groups according to different treatments. Group A(n=19) was given drug methotrexate conservative treatment; group B(n=30) was treated with B-ultrasound guided abortion; group C (n=40) was treated with uterine artery embolization combined with uterine curettage. The vaginal bleeding and treatment of patients were compared among the three groups. Results: The treatment success rate of group C was the highest, the time of serum β-HCG descending to normal level was the lowest, and the amount of vaginal bleeding after treatment was the least; the second was group B, and the last was group A,the differences were statistically significant (P<0.05). The decrease of serum β-HCG in the group B and group C was significantly higher than that in group A 4d and 7d after treatment, the decrease of group C was the greatest 7d after treatment (P<0.05). The time of hospitalization and the cost of hospitalization in group B were lower than that of group C and group A, but the rate of blood transfusion was high, and the difference was statistically significant (P<0.05). Conclusion: Uterine artery embolization combined with uterine curettage in the treatment of CSP has the advantages of higher cure rate, less injury and quick recovery after operation. Its clinical efficacy is the best under the circumstances of economic conditions.
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