子宫动脉栓塞术联合甲氨蝶呤灌注对子宫切口瘢痕妊娠术后β-人绒毛膜促性腺激素水平和月经恢复的影响-现代医学

子宫动脉栓塞术联合甲氨蝶呤灌注对子宫切口瘢痕妊娠术后β-人绒毛膜促性腺激素水平和月经恢复的影响

单位：衡水市第五人民医院妇产科, 河北衡水 053000

分类号：R714.22

出版年·卷·期（页码）：2020·39·第六期（728-731）

摘要：

目的： 观察子宫动脉栓塞术联合甲氨蝶呤灌注对子宫切口瘢痕妊娠术后患者β-人绒毛膜促性腺激素（β-hCG）水平和月经恢复的影响。方法： 选取2015年6月至2017年7月本院收治的剖宫产后瘢痕妊娠（CSP）患者71例，采用数字表法随机分为观察组35例和对照组36例。观察组行双侧子宫动脉栓塞术联合甲氨蝶呤灌注治疗，对照组仅接受双侧子宫动脉栓塞术，不灌注甲氨蝶呤。检测治疗前和治疗后第1、4、7、14、20天β-hCG水平，并计算血清β-hCG水平下降率，统计两组月经恢复时间以及治疗前后月经周期、经量、经期。结果： 随时间延长，两组血清β-hCG水平均呈现明显的下降趋势，至14 d时均基本降至正常范围，期间观察组血清β-hCG水平下降率高于对照组（P<0.01）。观察组月经恢复时间短于对照组（t=-8.440，P<0.001）。治疗前后两组月经周期、经量及经期比较，差异均无统计学意义（t值分别为1.019、-0.654、-0.436，P值分别为0.312、0.515、0.664）。结论： 与子宫动脉栓塞术相比，子宫动脉栓塞术联合甲氨蝶呤灌注治疗子宫切口瘢痕妊娠可以更显著地降低β-hCG水平，且不影响月经，治疗效果满意。

Objective: To observe the influence of the uterine arterial embolization combined with methotrexate on β-hCG and menstruation in women with cesarean scar pregnancy(CSP).Methods: A total of 71 women with CSP were divided into the observation group (n=35) and the control group (n=36) by random number table. The observation group were received uterine arterial embolization combine with methotrexate, the control group were received uterine arterial embolization without methotrexate. The β-hCG levels were tested before treatment and after treatment for 1, 4, 7, 14, 20 days, and serum β-hCG levels droop rate were counted, then the menstruation recovery time, menstrual cycle, menstrual volume and menstrual period were calculated before and after treatment. Results: Extension with time, the β-hCG levels were reduced, fell to normal by 12 days, and the serum β-hCG levels droop rate was higher in the observation group than that in the control group(P<0.05). The menstruation recovery time was lower in the observation group than that in the control group(t=-8.440, P<0.001). There were no statistical significances on menstrual cycle, menstrual volume and menstrual period before and after treatment between two groups(t=-1.019,-0.654,-0.436, P=0.312, 0.515, 0.664). Conclusion: Compared with uterine arterial embolization, uterine arterial embolization combined with methotrexate can significantly reduce β-hCG levels without effect ofmenstruation, and the therapeutic effect is satisfactory.

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