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目的:对比分析子宫动脉栓塞联合甲氨蝶呤(MTX)与单独使用肌注甲氨蝶呤治疗子宫切口妊娠的临床效果。方法:选取我院于2009年6月-2013年6月收治的80例子宫切口妊娠患者为研究对象,随机分为对照组和实验组,每组各40例。实验组采用子宫动脉插管,通过导管灌注甲氨蝶呤(MTX)50~100mg至子宫动脉,灌注毕则采用明胶海绵颗粒栓塞双侧子宫动脉;对照组采用单独肌注甲氨蝶呤治疗。结果:实验组β-HCG下降恢复至正常水平时间、阴道流血量、术后住院时间、并发症发生率均少于对照组,两组间差异具有统计学意义(P<0.05)。结论:子宫动脉栓塞联合甲氨蝶呤(MTX)治疗子宫切口妊娠具有微创、预防子宫大出血等优势,显著降低子宫切除率和并发症发生率,值得临床推广应用。
Objective: To compare the clinical effects of uterine artery embolization combined with methotrexate (MTX) and methotrexate alone in the treatment of uterine incision pregnancy. Methods: Eighty pregnant women with uterine incision pregnancy treated in our hospital from June 2009 to June 2013 were selected as study subjects and randomly divided into control group and experimental group, 40 cases in each group. In the experimental group, uterine arterial cannulation was performed, and methotrexate (MTX) 50-100 mg was infused into the uterine artery through the catheter. The bilateral uterine arteries were embolized with gelatin sponge particles. The control group was treated with methotrexate alone. Results: The decline of β-HCG in experimental group returned to normal level, vaginal bleeding volume, postoperative hospital stay and complication rate were lower than those in control group. The difference between the two groups was statistically significant (P <0.05). Conclusion: Uterine artery embolization combined with methotrexate (MTX) in the treatment of uterine incision pregnancy has the advantages of minimally invasive, prevent bleeding and other hysterons, significantly reducing the incidence of hysterectomy and complications, worthy of clinical application.