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[绝经7周内Ⅱ型和Ⅲ型剖宫产瘢痕妊娠两种治疗方法安全性的比较]

[Comparison of the safety of two treatment methods of cesarean scar pregnancy of typeⅡ and Ⅲ in menopause within 7 weeks].

作者信息

Wei X Y, Yu X L

机构信息

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2017 Jul 25;52(7):449-454. doi: 10.3760/cma.j.issn.0529-567X.2017.07.004.

DOI:10.3760/cma.j.issn.0529-567X.2017.07.004
PMID:28797151
Abstract

To comparison of the safety of two treatment methods of cesarean scar pregnancy (CSP) of typeⅡ and Ⅲ in menopause within 7 weeks. Totally 70 cases of CSP of typeⅡ and Ⅲ within 7 weeks of the last menstrual period, hospitalized within Peking University First Hospital from January 2009 to May 2016, had been retrospectively studied in two groups of different treatments. The methotrexate (MTX) treatment group included 37 cases receiving ultrasound-guided complete curettage of uterine cavity combined with MTX therapy, while the uterine artery embolization (UAE) group had 33 cases treated with UAE combined with MTX therapy and subsequent ultrasound-guided complete curettage of uterine cavity. The bleeding measurements during operation had been documented and compared for the study. The comparative difference of bleeding measurements between the MTX treatment group and the UAE group was insignificant from the statistical perspective (median: 5.0 vs 5.0 ml, 0.716).The comparative difference of the duration (median: 2.0 vs 6.0 days, 0.01) and expenses (median: 2 832.1 vs 10 147.1 yuan, 0.01) for hospitalization between the MTX treatment group and the UAE group were significant from the statistical perspective. The bleeding risks may not increase during the treatment of ultrasound-guided complete curettage of uterine cavity combined with MTX therapy for CSP patients of type Ⅱ and Ⅲwithin 7 weeks of the last menstrual period. Meanwhile, the UAE adverse effects and complications will be avoided, and the duration and expenses for hospitalization will be reduced.

摘要

比较绝经7周内Ⅱ型和Ⅲ型剖宫产瘢痕妊娠(CSP)两种治疗方法的安全性。回顾性研究2009年1月至2016年5月在北京大学第一医院住院的末次月经7周内的70例Ⅱ型和Ⅲ型CSP患者,分为两组采用不同治疗方法。甲氨蝶呤(MTX)治疗组37例,采用超声引导下清宫联合MTX治疗;子宫动脉栓塞术(UAE)组33例,采用UAE联合MTX治疗及后续超声引导下清宫。记录并比较术中出血量。MTX治疗组与UAE组术中出血量的比较差异无统计学意义(中位数:5.0 vs 5.0 ml,0.716)。MTX治疗组与UAE组住院时间(中位数:2.0 vs 6.0天,0.01)和费用(中位数:2 832.1 vs 10 147.1元,0.01)的比较差异有统计学意义。末次月经7周内Ⅱ型和Ⅲ型CSP患者采用超声引导下清宫联合MTX治疗时出血风险可能不会增加。同时,可避免UAE的不良反应和并发症,缩短住院时间并降低费用。

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