分析宫腔镜联合甲氨蝶呤及米非司酮对子宫切口妊娠患者的疗效及并发症(1)
【摘要】 目的：分析宫腔镜联合甲氨蝶呤及米非司酮对子宫切口妊娠患者的疗效及并发症。方法：选取2014年1月-2017年1月本院收治的子宫切口妊娠患者40例，与患者及家属说明治疗方案后按照患者及家属的意愿分为对照组与研究组，对照组17例，研究组23例。对照组采用保守治疗即甲氨蝶呤肌肉注射+米非司酮口服，研究组在对照组的基础上在全麻下行宫腔镜手术治疗，比较两组患者的治疗效果及并发症的发生情况。结果：研究组人绒毛膜促性腺激素(β-hCG)下降至正常水平的时间及包块消失的时间明显快于对照组，妊娠终止率明显高于对照组，并发症发生率低于对照组，两组比较差异均有统计学意义(P<0.05)。结论：宫腔镜联合甲氨蝶呤及米非司酮对子宫切口妊娠患者的治疗具有创伤小、恢复快、并发症少、妊娠终止率高等优点，可大大缩短患者的病程，其疗效肯定，值得在临床中推广应用。
【关键词】 宫腔镜； 甲氨蝶呤； 米非司酮； 子宫切口妊娠
Analysis of the Efficacy and Complications of Hysteroscopy Combined with Methotrexate and Mifepristone for Patients with Cesarean Scar Pregnancy/WANG Tingting.//Medical Innovation of China，2018，15(07)：059-062
, http://www.100md.com
【Abstract】 Objective：To analyze the efficacy and comlications of hysteroscopy combined with Methotrexate and Mifepristone on cesarean scar pregnancy(CSP).Method：A total of 40 cases on cesarean scar pregnancy in our hospital were selected from January 2014 to January 2017，they were randomly divided into the control group of 17 cases and the study group of 23 cases in accordance with the wishes of patients and their families for treatment.The control group was treated by conservative treatment with Methotrexate Intramuscular Injection + Mifepristone，the study group on the base of that was given hysteroscopic surgery in general anesthesia.The therapeutic results and complications were compared between two groups.Result：Time of β-hCG decreased to a normal level and time of the mass disappearance in the study groupwas faster than those in the control group，the rate of termination pregnancy in the study group was significantly higher than that in the control group，the complication rate in the study group was lower than that in the control group，the differences were statistically significant(P<0.05).Conclusion：The treatment of hysteroscopy combined with Methotrexate and Mifepristone on CSP is less trauma，faster recovery，fewer complications， higher rates of termination pregnancy， can greatly shorten the duration of the patient，its efficacy is sure，it is worthy of clinical application.
, 百拇医药
【Key words】 Hysteroscopy； Methotrexate； Mifepristone； Uterine incision pregnancy
First-author’s address：Jingmen City Duodao District People’s Hospital，Jingmen 448000，China
doi：10.3969/j.issn.1674-4985.2018.07.017
子宫切口妊娠是临床上较为少见的一种特殊妊娠[1]，此种妊娠属于异位妊娠[2]，是经产妇上次剖宫产形成子宫切口瘢痕，胚胎到达子宫后着床于子宫瘢痕之上形成的妊娠[3]，早期可与正常妊娠无明显差别，但随着孕期的增长，胚胎逐渐发育，孕囊的绒毛与子宫切口瘢痕处发生粘连，进一步发展会穿透子宫壁而导致子宫破裂，造成大出血[4]。此种妊娠属于剖宫产的远期并发症[5]，若没有得到早期诊断与处理，严重可出现休克，危及患者生命[6]。因此，早诊断、早治疗是目前临床上处理子宫切口妊娠的主要手段[7]。但目前單纯药物保守治疗效果并不理想，且药物不良反应与并发症出现率较大，而传统刮宫术则易造成大出血[8]，因此，子宫切口妊娠的处理是临床中较为棘手的问题。随着科学技术的发展，内窥镜技术逐渐发展成熟并成功应用于临床，随之宫腔镜技术也得以迅速发展，目前已广泛在临床中应用开来，并在治疗子宫切口妊娠上取得了良好的治疗效果[9]。为分析宫腔镜联合甲氨蝶呤及米非司酮对子宫切口妊娠患者的疗效及并发症，本院将2014年1月-2017年1月收治的40例子宫切口妊娠患者按照患者及家属的意愿，分为对照组与研究组进行对比治疗，并将其治疗结果及数据进行统计学处理，具体报告如下。, http://www.100md.com(王婷婷)
【关键词】 宫腔镜； 甲氨蝶呤； 米非司酮； 子宫切口妊娠
Analysis of the Efficacy and Complications of Hysteroscopy Combined with Methotrexate and Mifepristone for Patients with Cesarean Scar Pregnancy/WANG Tingting.//Medical Innovation of China，2018，15(07)：059-062
, http://www.100md.com
【Abstract】 Objective：To analyze the efficacy and comlications of hysteroscopy combined with Methotrexate and Mifepristone on cesarean scar pregnancy(CSP).Method：A total of 40 cases on cesarean scar pregnancy in our hospital were selected from January 2014 to January 2017，they were randomly divided into the control group of 17 cases and the study group of 23 cases in accordance with the wishes of patients and their families for treatment.The control group was treated by conservative treatment with Methotrexate Intramuscular Injection + Mifepristone，the study group on the base of that was given hysteroscopic surgery in general anesthesia.The therapeutic results and complications were compared between two groups.Result：Time of β-hCG decreased to a normal level and time of the mass disappearance in the study groupwas faster than those in the control group，the rate of termination pregnancy in the study group was significantly higher than that in the control group，the complication rate in the study group was lower than that in the control group，the differences were statistically significant(P<0.05).Conclusion：The treatment of hysteroscopy combined with Methotrexate and Mifepristone on CSP is less trauma，faster recovery，fewer complications， higher rates of termination pregnancy， can greatly shorten the duration of the patient，its efficacy is sure，it is worthy of clinical application.
, 百拇医药
【Key words】 Hysteroscopy； Methotrexate； Mifepristone； Uterine incision pregnancy
First-author’s address：Jingmen City Duodao District People’s Hospital，Jingmen 448000，China
doi：10.3969/j.issn.1674-4985.2018.07.017
子宫切口妊娠是临床上较为少见的一种特殊妊娠[1]，此种妊娠属于异位妊娠[2]，是经产妇上次剖宫产形成子宫切口瘢痕，胚胎到达子宫后着床于子宫瘢痕之上形成的妊娠[3]，早期可与正常妊娠无明显差别，但随着孕期的增长，胚胎逐渐发育，孕囊的绒毛与子宫切口瘢痕处发生粘连，进一步发展会穿透子宫壁而导致子宫破裂，造成大出血[4]。此种妊娠属于剖宫产的远期并发症[5]，若没有得到早期诊断与处理，严重可出现休克，危及患者生命[6]。因此，早诊断、早治疗是目前临床上处理子宫切口妊娠的主要手段[7]。但目前單纯药物保守治疗效果并不理想，且药物不良反应与并发症出现率较大，而传统刮宫术则易造成大出血[8]，因此，子宫切口妊娠的处理是临床中较为棘手的问题。随着科学技术的发展，内窥镜技术逐渐发展成熟并成功应用于临床，随之宫腔镜技术也得以迅速发展，目前已广泛在临床中应用开来，并在治疗子宫切口妊娠上取得了良好的治疗效果[9]。为分析宫腔镜联合甲氨蝶呤及米非司酮对子宫切口妊娠患者的疗效及并发症，本院将2014年1月-2017年1月收治的40例子宫切口妊娠患者按照患者及家属的意愿，分为对照组与研究组进行对比治疗，并将其治疗结果及数据进行统计学处理，具体报告如下。, http://www.100md.com(王婷婷)