B超引导下局部不同剂量MTX注射治疗剖宫产后疤痕妊娠疗效管理分析
[摘要] 目的 探讨剖宫产后瘢痕妊娠经孕囊局部注射MTX 的有效剂量及治疗管理效果。方法 以孕周在5～9周的40例切口瘢痕妊娠为研究对象，经B超引导下局部注射不同剂量M TX，剂量从5 mg逐渐加至20 mg，每1剂量观察10例，术后B超监测孕囊大小、张力、孕囊周边血流，血β-hCG、血孕酮值以及住院时间。结果 血β-hCG和血孕酮的下降速度与MTX用量大小存在一定关系。5 mg和20 mg剂量组间差异有统计学意义（P < 0.05），10 mg和15 mg 剂量组间差异无统计学意义（P<0.05）。住院时间比较，20 mg组<10 mg组和15 mg组<5 mg组。 结论 该研究显示切口妊娠经B超引导下局部MTX注射有效用量为20 mg，局部病灶注射可杀死胚胎，迅速降低血β-hCG和血孕酮，缩短住院时间。
[关键词] 剖宫产后疤痕妊娠；局部注射；甲氨蝶呤；治疗管理
[中图分类号] R714 [文献标识码] A [文章编号] 1672-5654（2016）02（c）-0015-03
[Abstract] Objective To explore effective dose and management effect of local injections MTX though gestational for sac post-cesarean scar pregnancy. Methods Selected 40 cases incision scar pregnancy whoes gestational age were 5 to 9 weeks as the object， different MTX doses were local injected under ultrasound guiding， the dose gradually add to 20 mg from 5 mg， 10 cases in each dose group， postoperative， pregnant bursa size， tension， pregnant bursa， peripheral blood flow， β-hCG， blood progesterone values， and the length of time were monitored by B ultrasonic. Results There is a certain relationship between the falling speed of β-hCG and blood progesterone and the MTX using dosage. The difference between 5 mg and 20 mg dose groups was statistically significant（P<0.05）， there was no statistically significant difference between 10 mg and 15 mg dose group（P<0.05）. Length of hospital stay 20 mg group < 10mg and 15mg group < 5 mg group. Conclusion This study indicated that local injection MTX effective dosage was 20 mg...
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