中医联合甲氨蝶呤治疗剖宫产术后瘢痕妊娠的临床疗效

发布时间：2018-05-11 23:37

本文选题：中药 + 杀胚消症方　；参考：《中国妇幼保健》2016年23期

【摘要】：目的分析中药杀胚消症方辅助甲氨蝶呤联合治疗剖宫产后瘢痕妊娠的临床效果。方法选取98例剖宫产术后并发瘢痕妊娠妇女,采取抛掷硬币的方式进行随机分组,分为联合组49例、对照组49例,两组均采用宫颈孕囊及周围组织进行局部注射甲氨蝶呤(50 mg/m~2)进行杀胚治疗,联合组同时静滴杀胚消症方进行辅助治疗。结果联合组的一次杀胚成功率(77.6%)显著高于对照组(46.9%)(P0.05),联合组的中转手术治疗率(10.2%)显著低于对照组(26.5%)(P0.05)。联合组的β-hCG达标时间、阴道出血持续时间、子宫下段异常回声消失时间、月经复潮时间均显著低于对照组(P0.05)。治疗后第7天、14天、28天联合组患者的β-hCG水平均显著低于对照组(P0.05)。联合组的腹痛发生率、恶心呕吐发生率、腹泻发生率、白细胞减少率、肝损害发生率与对照组比较,差异均不具有统计学意义(P0.05)。结论中药杀胚消症方辅助甲氨蝶呤联合治疗剖宫产后瘢痕妊娠具有更高的临床成功率,能够更显著降低β-hCG水平及改善临床症状。
[Abstract]:Objective to analyze the clinical effect of combined methotrexate (MTX) in treating cicatricial pregnancy after cesarean section. Methods 98 pregnant women with scar after cesarean section were randomly divided into two groups: the combined group (n = 49) and the control group (n = 49). Both groups were treated with local injection of methotrexate 50 mg / m ~ (2) by cervical pregnancy sac and surrounding tissues. Results the success rate of single embryo killing in the combined group was significantly higher than that in the control group (46.9%, P 0.05), and in the combined group, the rate of transmissive operation was 10.2%, which was significantly lower than that in the control group (26.5%, P 0.05). In the combined group, the time of 尾 -hCG reaching the standard, the duration of vaginal bleeding, the time of disappearance of abnormal echo in the lower uterine segment, and the time of menstrual resuscitation were significantly lower than those of the control group (P 0.05). The level of 尾 -hCG in the combined group was significantly lower than that in the control group on the 7th day and 14th day and 28th day after treatment. The incidence of abdominal pain, nausea and vomiting, diarrhea, leukopenia and liver damage in the combined group were not significantly different from those in the control group (P 0.05). Conclusion the treatment of scar pregnancy with methotrexate in combination with Shabsixiao decoction has higher clinical success rate, lower 尾 -hCG level and ameliorated clinical symptoms.
【作者单位】：四川大学华西药学院;成都市妇女儿童中心医院;
【分类号】：R714.22

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