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目的探讨子宫动脉灌注栓塞术治疗剖宫产瘢痕部位妊娠的临床疗效。方法 80例剖宫产术后子宫瘢痕妊娠患者,随机分为观察组与对照组,每组40例。观察组患者实施子宫动脉甲氨蝶呤(MTX)灌注联合栓塞后清宫术治疗,对照组患者行MTX治疗后实施清宫术治疗。观察两组疗效。结果观察组治疗有效率为97.5%,对照组治疗有效率为62.5%,观察组治疗有效率明显高于对照组,差异具有统计学意义(P<0.05)。观察组患者住院时间(11.9±2.6)d,显著短于对照组(23.3±5.1)d,,差异具有统计学意义(P<0.05),两组患者术中出血量、绒毛促性腺激素(HCG)恢复时间等指标比较差异无统计学意义(P>0.05)。观察组患者不良反应发生率为10.0%,对照组患者不良反应发生率为40.0%。两组患者不良反应发生率比较差异具有统计学意义(P<0.05)。结论子宫动脉MTX灌注联合栓塞后清宫术能够有效治疗剖宫产瘢痕部位妊娠,具有非常明显的治疗效果,值得临床应用与推广。
Objective To investigate the clinical efficacy of uterine arterial infusion embolization in the treatment of cesarean scar pregnancy. Methods 80 cases of uterine scar pregnancy after cesarean section were randomly divided into observation group and control group, 40 cases in each group. Observation group patients underwent uterine artery methotrexate (MTX) perfusion combined with curettage curetreatment, patients in the control group after MTX treatment of curettage. The two groups were observed. Results The effective rate of observation group was 97.5%, while that of control group was 62.5%. The effective rate of observation group was significantly higher than that of control group (P <0.05). The length of hospital stay (11.9 ± 2.6) d in the observation group was significantly shorter than that in the control group (23.3 ± 5.1) d, and the difference was statistically significant (P <0.05). The blood loss, villous gonadotropin ) Recovery time and other indicators showed no significant difference (P> 0.05). The incidence of adverse reactions in the observation group was 10.0%, while the incidence of adverse reactions in the control group was 40.0%. There was significant difference between the two groups in the incidence of adverse reactions (P <0.05). Conclusion Uterine artery MTX perfusion combined with post-embolization curettage can effectively treat cesarean section scar pregnancy, has a very significant therapeutic effect, it is worth clinical application and promotion.