姚晓芳

[摘要] 目的 分析疤痕妊娠患者接受甲氨蝶呤聯合子宫动脉栓塞治疗的临床应用价值。 方法 该次方便选择2017年1月—2019年2月该院收治的60例疤痕妊娠患者为研究对象，参照计算机随机抽选结果分为观察组与对照组，对照组患者单纯接受甲氨蝶呤注射治疗，观察组患者接受甲氨蝶呤注射联合子宫动脉栓塞治疗，治疗后两组患者均接受清宫术，比较治疗效果，统计并分析各组患者临床相关指标差异。计算各组不良反应发生率。结果 观察组患者治疗总有效率明显高于对照组（P<0.05），同时，观察组患者术中出血量（104.39±11.23）mL少于对照组，阴道流血时间（5.33±1.02）d、包块完全消失时间（16.44±2.01）d、HCG恢复正常时间（19.38±1.01）h、住院总时间（8.03±1.12）d均明显短于对照组（t=30.48、15.49、26.36、18.09、20.38，P<0.05）。观察组患者术后发生不良反应的概率较对照组相比更低（P<0.05）。结论 疤痕妊娠患者接受甲氨蝶呤联合子宫动脉栓塞治疗效果更佳，能够减少出血量，加速患者康复，预防不良反应，值得临床应用与推广。

[关键词] 甲氨蝶呤;子宫动脉栓塞;疤痕妊娠;临床分析

[中图分类号] R71          [文献标识码] A          [文章编号] 1674-0742（2019）11（a）-0073-03

Clinical Analysis of Methotrexate Combined with Uterine Artery Embolization in the Treatment of Scar Pregnancy

YAO Xiao-fang

Department of Obstetrics and Gynecology， Xinghua Hospital of Traditional Chinese Medicine， Xinghua， Jiangsu Province， 225700 China

[Abstract] Objective To analyze the clinical value of methotrexate combined with uterine artery embolization in patients with scar pregnancy. Methods Sixty patients with scar pregnancy admitted to the hospital from January 2017 to February 2019 were Conveniently selected as the study subjects. The results of computer sampling were divided into observation group and control group. The control group received methotrexate injection alone. Patients in the observation group received methotrexate injection combined with uterine artery embolization. After treatment， both groups received uterine curettage， and the treatment effects were compared. The clinically relevant indicators of each group were statistically analyzed. The incidence of adverse reactions in each group was calculated. Results The total effective rate of the observation group was significantly higher than that of the control group （P<0.05）. At the same time， the intraoperative blood loss （104.39±11.23） mL was lower in the observation group than in the control group， and the vaginal bleeding time （5.33±1.02） d. The complete disappearance time of the block （16.44±2.01） d， the normal time of HCG recovery （19.38±1.01）h， and the total hospitalization time （8.03±1.12） d were significantly shorter than the control group （t=30.480， 15.490， 26.360， 18.090， 20.380， P<0.05）. The probability of adverse reactions in the observation group was lower than that in the control group （P<0.05）. Conclusion Patients with scar pregnancy have better treatment with methotrexate combined with uterine artery embolization， which can reduce the amount of bleeding， accelerate the recovery of patients and prevent adverse reactions. It is worthy of clinical application and promotion.

[Key words] Methotrexate; Uterine artery embolization; Scar pregnancy; Clinical analysis

疤痕妊娠隶属较特殊的一种异位妊娠情况，指的是曾经接受过剖宫产的患者再次妊娠，受精卵于子宮的疤痕位置着床、生长。临床症状表现为伴随孕囊的不断增大，阴道发生不规则流血情况，严重甚至出现子宫破裂问题，对患者的生命安全造成危害[1]。因而，及早诊断并终止妊娠至关重要。该文以2017年1月—2019年2月该院收治60例疤痕妊娠患者为例，探究甲氨蝶呤联合子宫动脉栓塞治疗的效果，现报道如下。

1  资料与方法

1.1  一般资料

该次方便选择该院收治的60例疤痕妊娠患者为研究对象，参照计算机随机抽选结果分为观察组与对照组，对照组共计患者30例，最小年龄为24岁，最大年龄为35岁，平均年龄（29.4±1.1）岁，孕周短则4周，长则12周，平均孕周（8.2±0.3）周，其中14例患者曾经1次接受过剖宫产，16例患者曾经2次及以上接受过剖宫产。……