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目的:分析剖宫产瘢痕妊娠行氨甲喋呤(MTX)胎囊注射后B超监测下清宫术和单纯MTX胎囊注射两种治疗方法的疗效。方法:回顾性分析35例剖宫产瘢痕妊娠患者的临床资料,按其治疗方法分为两组,一组行MTX胎囊注射后B超监测下清宫术(清宫组22例),一组行单纯MTX胎囊注射术(MTX组13例),对比两组疗效。结果:35例患者均未切除子宫。清宫组22例无子宫穿孔,1例发生宫腔粘连;清宫组阴道出血时间、血人绒毛膜促性腺激素(HCG)转阴时间及B超下局部包块吸收时间分别为(6.9±1.6)、(16.1±2.6)和(8.2±2.6)d,均短于MTX组的(15.8±1.6)、(24.8±8.1)和(43.1±19.1)d(均P<0.01);清宫组恢复正常月经时间为(54.8±9.2)d,长于MTX组的(35.5±4.8)d(P<0.01)。结论:MTX胎囊注射后B超监测下清宫术及单纯MTX胎囊注射均可用于剖宫产瘢痕妊娠的治疗,前者疗效优于后者。
OBJECTIVE: To analyze the curative effect of two kinds of curettage methods of curettage and MTX fetal capsule injection after B-monitoring of methotrexate (MTX) fetal sac pregnancy after cesarean scar pregnancy. Methods: A retrospective analysis of 35 cases of cesarean scar pregnancy in patients with clinical data, according to their treatment methods are divided into two groups, a group of MTX fetal capsule injection B-monitoring under the curettage (Qing group 22 cases), a group of Simple MTX fetal capsule injection (MTX group of 13 cases), the two groups were compared. Results: None of the 35 patients had a uterus. There were 22 cases without uterine perforation and 1 case intrauterine adhesions in Qing group. The time of vaginal bleeding, the time of HCG and the time of subsidence in local mass in group B were (6.9 ± 1.6) , (16.1 ± 2.6), and (8.2 ± 2.6) d, respectively, were shorter than those in MTX group (15.8 ± 1.6), (24.8 ± 8.1) and (43.1 ± 19.1) d Time was (54.8 ± 9.2) d, longer than that of MTX group (35.5 ± 4.8) d (P <0.01). Conclusion: MTX fetal capsule injection B-monitoring under the curettage and simple MTX fetal capsule injection can be used for the treatment of cesarean scar pregnancy, the former is better than the latter.