| 中西医结合治疗早期剖宫产子宫瘢痕妊娠的临床观察 |
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| 引用本文： | 王璐璐,盛少琴,叶会玲.中西医结合治疗早期剖宫产子宫瘢痕妊娠的临床观察[J].中华全科医学,2018,16(7):1148-1150. |
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| 作者姓名： | 王璐璐 盛少琴 叶会玲 |
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| 作者单位： | 1. 浙江中西医结合医院妇产科, 浙江 杭州 310003; |
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| 基金项目： | 浙江省中医药科技计划项目(2017ZA057) |
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| 摘 要： | 目的 观察中西医联合治疗剖宫产后子宫瘢痕妊娠患者的临床疗效。 方法 以2015年9月-2017年9月于浙江中西医结合医院就诊并接受治疗的148例早期剖宫产子宫瘢痕妊娠患者为研究对象,分为对照组(74例)和研究组(74例)。对照组患者给予单纯西医治疗,研究组患者予以中西医结合治疗。统计2组患者药物保守治疗疗效,比较2组患者不同时间血清人绒毛膜促性腺激素(β-hCG)含量,记录患者住院时间和症状缓解时间,观察患者治疗期间药物不良反应情况。 结果 研究组单疗程杀胚成功率(78.38%)和保守治疗总体成功率(95.95%)均显著高于对照组(52.70%和85.14%;χ2=10.800、5.049;P=0.001、0.025);治疗7、14和28 d,研究组患者血清β-hCG含量水平均显著低于对照组(P<0.05);研究组患者住院时间、β-hCG含量达标时间、阴道出血持续时间、异常回声消失时间、月经恢复时间和孕囊病灶消失时间均显著低于对照组(均P<0.05);研究组患者药物不良反应发生率(13.51%)显著低于对照组(28.38%,χ2=4.937,P=0.026)。 结论 孕囊穿刺注射氨甲蝶呤+米非司酮口服联合杀胚消癥方可显著降低早期剖宫产子宫瘢痕妊娠患者β-hCG水平,提高保守治疗成功率,缩短康复周期,减少药物不良反应。
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| 关 键 词： | 剖宫产子宫瘢痕妊娠 中西医结合治疗 药物保守治疗 成功率 安全性 |
| 收稿时间： | 2018-01-06 |
Observe on the clinical efficacy of combination of traditional Chinese and Western medicine in the treatment of early cesarean scar pregnancy |
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| Affiliation: | Department of Obstetrics and Gynecology, the Integrated Traditional Chinese and Western Medicine Hospital of Zhejiang, Hangzhou, Zhejiang 310003, China |
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| Abstract: | Objective To observe the clinical effect of combination of traditional Chinese and Western medicine in the treatment of early cesarean scar pregnancy. Methods A total of 148 cases of early cesarean scar pregnancy were as research object whom received treatment in our hospital from September, 2015 to September, 2017, all the patients were divided into the control group (n=74) and the research group (n=74). The control group were given western medicine treatment. The study group were given combination of traditional Chinese and Western medicine. The efficacy of drug conservative treatment in two groups was statistically analyzed. The serum β-hCG levels at different times were compared between the two groups. The hospitalization time and symptom relief time were recorded, and the adverse drug reactions during treatment were observed. Results The success rate of embryo treatment (78.38%) and the total success rate of conservative treatment (95.95%) in the study group were significantly higher than those in the control group (52.70% and 85.14%, χ2=10.800, 5.049; P=0.001, 0.025). After the treatment of 7, 14 and 28 d, the level of serum β-hCG in the patients of the study group was significantly lower than that of the control group (P<0.05). The time of β-hCG level arrival, the time of abnormal echo disappearance, and the time of disappearance of gestational sac in the study group were significantly shorter than those in the control group (P<0.05). The incidence of adverse reactions in the study group (13.51%) was significantly lower than that in the control group (28.38%, χ2=4.937, P=0.026). Conclusion Combined therapy of gestational sac puncture injection of methotrexate + mifepristone combined embryocide Xiaozheng decoction of traditional Chinese medicine and Western medicine, can significantly reduce the early cesarean scar pregnancy with β-hCG secretion, improve the success rate of conservative treatment, shorten the recovery period, reduce adverse drug reactions during the treatment period. |
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