【摘要】 目的探讨B超引导清宫术联合甲氨蝶呤(MTX)与米非司酮治疗子宫瘢痕妊娠的疗效,并观察其对血清β-h CG水平的影响。方法选取该院2014年1月-2016年12月收治的240例子宫瘢痕妊娠患者为研究对象,将其随机分为4组,分别为治疗Ⅰ组(B超引导清宫术联合肌内注射MTX+口服米非司酮)、治疗Ⅱ组(肌内注射MTX)、治疗组Ⅲ组(口服米非司酮)、治疗Ⅳ组(无B超引导清宫术),每组各60例。结果治疗Ⅰ组治愈57例(95.0%),治疗Ⅱ组治愈48例(80.0%),治疗Ⅲ组治愈49例(81.7%),治疗Ⅳ组治愈50例(83.3%);与治疗Ⅱ组、Ⅲ组、Ⅳ组相比较,治疗Ⅰ组的治愈率、β-hCG水平下降最高,恢复时间更短;治疗Ⅰ组月经复潮时间长于治疗Ⅱ组、Ⅳ组,且治疗Ⅳ组不良反应总发生率明显低于治疗Ⅰ组和治疗Ⅲ组(P<0.05)。结论 B超引导清宫术联合肌内注射MTX与口服米非司酮比单纯肌内注射MTX、单纯口服米非司酮、单纯进行B超引导清宫术的临床效果更为显著,安全性好。更多还原

【Abstract】 Objective To explore the curative effect of B ultrasound-guided uterine curettage combined with methotrexate( MTX) and mifepristone in treatment of cesarean scar pregnancy( CSP),observe the effect on serum levels of β-human chorionic gonadotropin( β-h CG). Methods A total of 240 patients with CSP were selected from the Second People’s Hospital of Fengrun District from January 2014 to December 2016,then they were randomly divided into treatment Ⅰ group( B ultrasound-guided uterine curettage combined with intramuscular injection of MTX and oral administration of mifepristone),treatment Ⅱ group( intramuscular injection of MTX),treatment Ⅲ group( oral administration of mifepristone),and treatment Ⅳ group( uterine curettage),60 patients in each group. Results The cure rates in treatment Ⅰ group,treatment Ⅱ group,treatment Ⅲ group,and treatment Ⅳ group were 95. 0%( 57 patients),80. 0%( 48 patients),81. 7%( 49 patients),and 83. 3%( 50 patients),respectively. Compared with treatment Ⅱ group,treatment Ⅲ group,and treatment Ⅳgroup,the cure rate and decreasing amplitude of β-h CG level in treatment Ⅰ group were the highest,the recovery time was the shortest.The recovery time of menstruation in treatment Ⅰ group was longer than that in treatment Ⅱ group and treatment Ⅳ group. The total incidence rate of adverse reactions in treatment Ⅳ group was statistically significantly lower than those in treatment Ⅰ group and treatment Ⅲgroup( P<0. 05). Conclusion Compared with simple intramuscular injection of MTX,simple oral administration of mifepristone,and simple uterine curettage,the clinical effect of B ultrasound-guided uterine curettage combined with methotrexate and mifepristone in treatment of CSP is more significant,and the safety is higher.更多还原