局部与全身联合应用甲氨蝶呤治疗孕8至14周剖宫产瘢痕妊娠的疗效
The Effectiveness of Combined Local and Systemic Methotrexate Treatment in Cesarean Scar Pregnancy Weeks 8 to 14.
作者信息
Van Xuyen, Bui Thuong, Dinh Hoang The, Van Thong, Tran Anh
机构信息
Department of Obstretric and Gynecology, Tu Du Maternal Hospital, Long An, Vietnam.
Department of Obstretric and Gynecology, University of Medicine and Pharmacy, Long An, Vietnam.
出版信息
Gynecol Minim Invasive Ther. 2023 Aug 10;12(3):170-174. doi: 10.4103/gmit.gmit_135_22. eCollection 2023 Jul-Sep.
OBJECTIVES
This study aims to identify the success rate and correlated factors of combined local and systemic methotrexate (MTX) injection treatment in cesarean scar pregnancy (CSP).
MATERIALS AND METHODS
The combined local and systemic MTX administration has been used for CSP weeks 8-14 at Tu Du Maternal Hospital; however, its effectiveness and correlated factors have not been closely investigated. This is a retrospective case series of 123 CSP patients between 8 and 14 weeks of gestation who were treated at Tu Du Hospital from the year 2016 to 2020.
RESULTS
The success rate, uterine-sparing rate, and side effects of MTX treatment are 50.4%, 95%, and 17.2%, respectively. The factors related to treatment failure with statistical significance included gestational age (odds ratio [OR] = 3.99), residual myometrial thickness >3 mm (OR = 0.37), and postprocedure gestational sac diameter (OR = 1.09).
CONCLUSION
Combined local and systemic MTX injection is minimally invasive and effective in CSP weeks 8-14. Therefore, it should be utilized routinely.
目的
本研究旨在确定剖宫产瘢痕妊娠（CSP）局部与全身联合应用甲氨蝶呤（MTX）注射治疗的成功率及相关因素。
材料与方法
在涂都妇产医院，局部与全身联合应用MTX治疗8 - 14周的CSP；然而，其有效性及相关因素尚未得到深入研究。这是一项回顾性病例系列研究，纳入了2016年至2020年在涂都医院接受治疗的123例妊娠8至14周的CSP患者。
结果
MTX治疗的成功率、子宫保留率及副作用分别为50.4%、95%和17.2%。与治疗失败相关且具有统计学意义的因素包括孕周（比值比[OR]=3.99）、肌层残余厚度>3 mm（OR = 0.37）及术后孕囊直径（OR = 1.09）。
结论
局部与全身联合MTX注射对8 - 14周的CSP微创且有效。因此，应常规使用。
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