【摘要】 目的 探讨子宫动脉栓塞术（UAE）联合甲氨蝶呤及宫孕方对剖宫产瘢痕妊娠（CSP）清宫术出血量、β-人绒毛膜促性腺激素（β-HCG）水平及月经恢复正常时间的影响。方法 选取浙江省宁海县第一医院2018年1月至2021年1月收治的66例CSP患者，收集其基线资料，按治疗方法将患者分为2组，其中29例行UAE+清宫术+甲氨蝶呤+宫孕方（观察组），37例行UAE+清宫术（对照组）。统计分析2组围术期指标、β-HCG水平与月经恢复正常时间以及不良反应发生率。结果 66例CSP患者年龄（34±4）岁，β-HCG水平（25 125±3 784）U/L、月经恢复时间（3.8±0.8）个月。观察组患者住院时间、术中出血量及阴道出血持续时间均少于对照组（P<0.05）。观察组患者血清β-HCG水平恢复正常时间和月经恢复正常时间均短于对照组（P<0.05）。观察组不良反应总发生率为10%，对照组不良反应总发生率为16%，差异无统计学意义（P>0.05）。结论子宫动脉栓塞联合甲氨蝶呤及宫孕方可有效减少CSP患者清宫术出血量，缩短β-HCG水平恢复正常时间和月经恢复正常时间，值得临床推广应用。更多还原

【Abstract】 Objective To investigate the effects of uterine artery embolization(UAE) combined with methotrexate and uterine pregnancy formula on the amount of bleeding, β-human chorionic gonadotropin(β-HCG)levels, and menstrual recovery time during cesarean section scar pregnancy(CSP) curettage. Methods A total of66 CSP patients admitted to the First Hospital of Ninghai County from January 2018 to January 2021 were select-ed, and their baseline data were collected. The patients were divided into an observation group(29 cases, under-going UAE + curettage surgery+methotrexate+uterine pregnancy formula) and a control group(37 cases, undergo-ing UAE + curettage surgery) depending on treatment methods. The perioperative indicators, β-HCG levels, menstrual recovery time, and incidence of adverse reactions of the two groups were statistically analyzed. Results The age of 66 CSP patients was(34±4) years old, with HCG levels of(25 125±3 784)U/L and menstrual recovery time of(3.8±0.8) months. The hospitalization time, intraoperative bleeding volume, and duration of vaginal bleeding in the observation group were significantly less than those in the control group(P<0.05). The recovery time of serum β-HCG levels and menstrual cycle in the observation group was significantly shorter than that in the control group(P<0.05). The total incidence of adverse reactions in the observation group and the control group was 10%and 16%, respectively, with no statistically significant difference(P>0.05). Conclusion The combination of methotrexate and uterine pregnancy formula can effectively reduce the amount of bleeding during curettage in CSP patients, shorten the time for β-HCG levels to return to normal and menstrual recovery time, and is worthy of clinical promotion and application.更多还原