【摘要】 目的：分析宮腔鏡聯(lián)合甲氨蝶呤及米非司酮對(duì)子宮切口妊娠患者的療效及并發(fā)癥。方法：選取2014年1月-2017年1月本院收治的子宮切口妊娠患者40例，與患者及家屬說(shuō)明治療方案后按照患者及家屬的意愿分為對(duì)照組與研究組，對(duì)照組17例，研究組23例。對(duì)照組采用保守治療即甲氨蝶呤肌肉注射+米非司酮口服，研究組在對(duì)照組的基礎(chǔ)上在全麻下行宮腔鏡手術(shù)治療，比較兩組患者的治療效果及并發(fā)癥的發(fā)生情況。結(jié)果：研究組人絨毛膜促性腺激素（β-hCG）下降至正常水平的時(shí)間及包塊消失的時(shí)間明顯快于對(duì)照組，妊娠終止率明顯高于對(duì)照組，并發(fā)癥發(fā)生率低于對(duì)照組，兩組比較差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：宮腔鏡聯(lián)合甲氨蝶呤及米非司酮對(duì)子宮切口妊娠患者的治療具有創(chuàng)傷小、恢復(fù)快、并發(fā)癥少、妊娠終止率高等優(yōu)點(diǎn)，可大大縮短患者的病程，其療效肯定，值得在臨床中推廣應(yīng)用。
　　【關(guān)鍵詞】 宮腔鏡； 甲氨蝶呤； 米非司酮； 子宮切口妊娠
　　Analysis of the Efficacy and Complications of Hysteroscopy Combined with Methotrexate and Mifepristone for Patients with Cesarean Scar Pregnancy/WANG Tingting.//Medical Innovation of China，2018，15（07）：059-062
　　【Abstract】 Objective：To analyze the efficacy and comlications of hysteroscopy combined with Methotrexate and Mifepristone on cesarean scar pregnancy（CSP）.Method：A total of 40 cases on cesarean scar pregnancy in our hospital were selected from January 2014 to January 2017，they were randomly divided into the control group of 17 cases and the study group of 23 cases in accordance with the wishes of patients and their families for treatment.The control group was treated by conservative treatment with Methotrexate Intramuscular Injection + Mifepristone，the study group on the base of that was given hysteroscopic surgery in general anesthesia.The therapeutic results and complications were compared between two groups.Result：Time of β-hCG decreased to a normal level and time of the mass disappearance in the study groupwas faster than those in the control group，the rate of termination pregnancy in the study group was significantly higher than that in the control group，the complication rate in the study group was lower than that in the control group，the differences were statistically significant（P<0.05）.Conclusion：The treatment of hysteroscopy combined with Methotrexate and Mifepristone on CSP is less trauma，faster recovery，fewer complications， higher rates of termination pregnancy， can greatly shorten the duration of the patient，its efficacy is sure，it is worthy of clinical application.
　　【Key words】 Hysteroscopy； Methotrexate； Mifepristone； Uterine incision pregnancy
　　First-author’s address：Jingmen City Duodao District People’s Hospital，Jingmen 448000，China
　　doi：10.3969/j.issn.1674-4985.2018.07.017
　　子宮切口妊娠是臨床上較為少見(jiàn)的一種特殊妊娠[1]，此種妊娠屬于異位妊娠[2]，是經(jīng)產(chǎn)婦上次剖宮產(chǎn)形成子宮切口瘢痕，胚胎到達(dá)子宮后著床于子宮瘢痕之上形成的妊娠[3]，早期可與正常妊娠無(wú)明顯差別，但隨著孕期的增長(zhǎng)，胚胎逐漸發(fā)育，孕囊的絨毛與子宮切口瘢痕處發(fā)生粘連，進(jìn)一步發(fā)展會(huì)穿透子宮壁而導(dǎo)致子宮破裂，造成大出血[4]。此種妊娠屬于剖宮產(chǎn)的遠(yuǎn)期并發(fā)癥[5]，若沒(méi)有得到早期診斷與處理，嚴(yán)重可出現(xiàn)休克，危及患者生命[6]。因此，早診斷、早治療是目前臨床上處理子宮切口妊娠的主要手段[7]。但目前單純藥物保守治療效果并不理想，且藥物不良反應(yīng)與并發(fā)癥出現(xiàn)率較大，而傳統(tǒng)刮宮術(shù)則易造成大出血[8]，因此，子宮切口妊娠的處理是臨床中較為棘手的問(wèn)題。隨著科學(xué)技術(shù)的發(fā)展，內(nèi)窺鏡技術(shù)逐漸發(fā)展成熟并成功應(yīng)用于臨床，隨之宮腔鏡技術(shù)也得以迅速發(fā)展，目前已廣泛在臨床中應(yīng)用開(kāi)來(lái)，并在治療子宮切口妊娠上取得了良好的治療效果[9]。為分析宮腔鏡聯(lián)合甲氨蝶呤及米非司酮對(duì)子宮切口妊娠患者的療效及并發(fā)癥，本院將2014年1月-2017年1月收治的40例子宮切口妊娠患者按照患者及家屬的意愿，分為對(duì)照組與研究組進(jìn)行對(duì)比治療，并將其治療結(jié)果及數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)處理，具體報(bào)告如下。

相關(guān)熱詞搜索：切口 并發(fā)癥 妊娠 子宮 療效