米非司酮联合超声引导下孕囊内注射甲氨蝶呤及清宫术治疗子宫瘢痕妊娠的临床观察(1)
【摘要】 目的：觀察米非司酮联合超声引导下孕囊内注射甲氨蝶呤及清宫术治疗子宫瘢痕妊娠的临床效果。方法：选取2018年1月-2019年5月本院收治的子宫瘢痕妊娠患者60例作为研究对象，按随机数字表法将其分为对照组与研究组，各30例。对照组口服米非司酮+肌肉注射甲氨蝶呤联合超声引导下行清宫术治疗，研究组口服米非司酮+超声引导下甲氨蝶呤妊娠囊内注射+超声引导下行清宫术治疗，比较两组距清宫术时间、清宫术中出血量、术后阴道流血时间、术后β-hCG情况、转经时间、住院时间、住院费用以及不良反应发生率。结果：研究组距清宫术时间、术后阴道流血时间均短于对照组，差异均有统计学意义(P<0.05);研究组清宫术中出血量明显少于对照组(P<0.05);研究组血β-hCG的下降率明显高于对照组(P<0.05);研究组血β-hCG转阴时间明显短于对照组(P<0.05);研究组转经时间与住院时间均短于对照组(P<0.05);研究组住院费用低于对照组(P<0.05);研究组不良反应发生率为10.00%，低于对照组的26.67%，但差异无统计学意义(P>0.05)。结论：米非司酮联合超声引导下孕囊内注射甲氨蝶呤及清宫术治疗子宫瘢痕妊娠效果显著，能明显缩短手术、转经及住院时间，减少出血量，较快恢复术后β-hCG水平，同时不良反应发生率较低。
【关键词】 米非司酮 甲氨蝶呤 清宫术 超声引导 子宫瘢痕妊娠
Clinical Observation of Mifepristone Combined with Ultrasound-guided Injection of Methotrexate into Pregnant Sac and Uterine Curettage for Treatment Cesarean Scar Pregnancy/JIANG Yanhua， HUANG Ruxiao， FENG Keren， CEN Zhenkao. //Medical Innovation of China， 2020， 17(03)： 0-028
[Abstract] Objective： To observe the clinical effect of Mifepristone combined with ultrasound-guided injection of Methotrexate into the pregnant sac and uterine curettage in the treatment of cesarean scar pregnancy. Method： A total of 60 patients with cesarean scar pregnancy admitted to our hospital from January 2018 to May 2019 were selected as the research objects. According to the random number table method， they were divided into the control group and the research group， 30 cases in each group. The control group received oral Mifepristone + intramuscular Methotrexate combined with ultrasound-guided uterine evacuation， the research group received oral Mifepristone + ultrasound-guided Methotrexate intra-capsular injection + ultrasound-guided uterine evacuation， the time between uterine curettage， blood loss during uterine cervix operation， postoperative vaginal bleeding time， postoperative β-hCG status， menstrual transition time， length of hospital stay， hospitalization cost and incidence of adverse reactions of two groups were compared. Result： The time between uterine curettage and the postoperative vaginal bleeding time in the research group were shorter than those in the control group (P<0.05). The amount of bleeding in the research group was significantly lower than that in the control group (P<0.05). The decrease rate of blood β-hCG in the research group was significantly higher than that in the control group (P<0.05). The blood β-hCG conversion time in the research group was significantly shorter than that in the control group (P<0.05). The menstrual transition time and hospitalization time of the research group were shorter than those of the control group (P<0.05). The hospitalization cost of the research group was lower than that of the control group (P<0.05). The incidence of adverse reactions in the research group was 10.00%， which was lower than 26.67% in the control group， but the difference was not statistically significant (P>0.05). Conclusion： Mifepristone combined with ultrasound-guided injection of Methotrexate into the pregnant sac and uterine curettage for the treatment of cesarean scar pregnancy has a significant effect， which can significantly shorten the time of operation， menstrual transition and hospitalization， reduce the amount of blood loss， and rapidly recover the level of β-hCG after surgery， while the incidence of adverse reactions is low., http://www.100md.com(蒋艳华 黄汝笑 冯科壬 岑振考)
【关键词】 米非司酮 甲氨蝶呤 清宫术 超声引导 子宫瘢痕妊娠
Clinical Observation of Mifepristone Combined with Ultrasound-guided Injection of Methotrexate into Pregnant Sac and Uterine Curettage for Treatment Cesarean Scar Pregnancy/JIANG Yanhua， HUANG Ruxiao， FENG Keren， CEN Zhenkao. //Medical Innovation of China， 2020， 17(03)： 0-028
[Abstract] Objective： To observe the clinical effect of Mifepristone combined with ultrasound-guided injection of Methotrexate into the pregnant sac and uterine curettage in the treatment of cesarean scar pregnancy. Method： A total of 60 patients with cesarean scar pregnancy admitted to our hospital from January 2018 to May 2019 were selected as the research objects. According to the random number table method， they were divided into the control group and the research group， 30 cases in each group. The control group received oral Mifepristone + intramuscular Methotrexate combined with ultrasound-guided uterine evacuation， the research group received oral Mifepristone + ultrasound-guided Methotrexate intra-capsular injection + ultrasound-guided uterine evacuation， the time between uterine curettage， blood loss during uterine cervix operation， postoperative vaginal bleeding time， postoperative β-hCG status， menstrual transition time， length of hospital stay， hospitalization cost and incidence of adverse reactions of two groups were compared. Result： The time between uterine curettage and the postoperative vaginal bleeding time in the research group were shorter than those in the control group (P<0.05). The amount of bleeding in the research group was significantly lower than that in the control group (P<0.05). The decrease rate of blood β-hCG in the research group was significantly higher than that in the control group (P<0.05). The blood β-hCG conversion time in the research group was significantly shorter than that in the control group (P<0.05). The menstrual transition time and hospitalization time of the research group were shorter than those of the control group (P<0.05). The hospitalization cost of the research group was lower than that of the control group (P<0.05). The incidence of adverse reactions in the research group was 10.00%， which was lower than 26.67% in the control group， but the difference was not statistically significant (P>0.05). Conclusion： Mifepristone combined with ultrasound-guided injection of Methotrexate into the pregnant sac and uterine curettage for the treatment of cesarean scar pregnancy has a significant effect， which can significantly shorten the time of operation， menstrual transition and hospitalization， reduce the amount of blood loss， and rapidly recover the level of β-hCG after surgery， while the incidence of adverse reactions is low., http://www.100md.com(蒋艳华 黄汝笑 冯科壬 岑振考)
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