向芬


摘要:目的 探析甲孕囊內注射與氨蝶呤肌肉注射聯合治療CSP(剖宮產術后子宮疤痕妊娠)的療效及時間指標。方法 選取本院2016年3月~2017年4月收治的92例CSP患者資料,因治療方案不同可分成兩組,行孕囊內注射聯合甲氨蝶呤肌注治療的46例患者設研究組,行甲氨蝶呤肌注治療的46例患者設對照組,對比兩組時間指標及不良反應。結果 研究組月經恢復、包塊吸收等所用的時間(35.16±5.07)d、(39.07±1.92)d比對照組短(P<0.05)。結論 CSP患者行孕囊內注射聯合甲氨蝶呤肌注治療可加快β-HCG恢復,縮短月經恢復及包塊吸收的時間。
關鍵詞:孕囊內注射;甲氨蝶呤;子宮疤痕妊娠;剖宮產術
中圖分類號:R714.22 文獻標識碼:A 文章編號:1006-1959(2017)24-0077-02
Efficacy Analysis of Methotrexate Intramuscular Injection Combined with Pregnancy Sac Injection in the Treatment of Cesarean Scar Pregnancy
XIANG Fen
(Department of Obstetrics and Gynecology,Huangmei Hospital of Traditional Chinese Medicine,Huangmei 435500,Hubei,China)
Abstract:Objective To investigate the efficacy and time index of CSP injection combined with methotrexate intramuscular injection in the treatment of uterine scar pregnancy after cesarean section.Methods 92 cases of CSP patients in our hospital from March 2016 to April 2017 were selected. They were divided into two groups because of different treatment protocols.46 cases were treated with intramuscular injection of methotrexate combined with methotrexate intramuscular injection,and the study group was established,for the 46 patients with intramuscular injection of methotrexate treatment control group,compared two groups of time index and adverse reactions.Results The menstrual recovery,packages with absorption time block(35.16±5.07)d,(39.07±1.92)d shorter than the control group(P<0.05).Conclusion The CSP patients with gestational sac injected methotrexate intramuscular injection treatment can accelerate the recovery of β-HCG,shorten the menstrual recovery and mass absorption time.
Key words:Methotrexate injection;Methotrexate;Uterine scar pregnancy;Cesarean section
CSP是一種比較特殊的異位妊娠,主要指妊娠囊在剖宮產子宮疤痕部位著床,臨床比較少見,患病率在異位妊娠中占6.5%左右,近幾年伴隨剖宮產率提高,CSP患病率明顯增加,但是發病病因尚不明確[1]。為此本院將近期收治的92例CSP患者作為探討對象,旨在研究甲孕囊內注射聯合氨蝶呤肌肉注射在CSP中的治療效果,現報道如下。
1資料與方法
1.1一般資料
選取本院2016年3月~2017年4月收治的92例CSP患者資料,因治療方案不同可分成研究組和對照組各46例。研究組中,年齡23~39歲,平均年齡(29.63±5.06)歲,孕次1~4次,平均孕次(2.48±1.03)次,孕周6~9 w,平均孕周(7.13±0.42)w;對照組中,年齡24~39歲,平均年齡(30.08±5.11)歲,孕次1~4次,平均孕次(2.69±0.97)次,孕周5~9 w,平均孕周(7.45±0.58)w。兩組基線資料比對,P>0.05。研究將配合研究、簽署同意書、意識清晰以及無傳染性疾病、心臟疾病、神經性疾病、造血系統疾病者納入;將溝通障礙、臨床資料殘缺、精神失常以及合并其它疾病者排除。
1.2方法
研究組行孕囊內注射聯合甲氨蝶呤肌注治療,1 mg/kg甲氨蝶呤行肌肉注射,總劑量不超過200 mg,治療后間隔3 d測量血清β-HCG,若血清β-HCG水平比治療前降低>50%,1 w后可予以甲氨蝶呤重復治療1次;初次……