β-HCG值对孕早期剖宫产瘢痕妊娠治疗的临床意义 : = The clinical significance of the levels of serum human chorionic gonadotropin-beta in treatment of cesarean scar pregnancy due to uterine-incision delivery in early gestation

目的研究人绒毛膜促性腺激素(β-HCG)值对孕早期剖宫产瘢痕妊娠(CSP)治疗的临床意义。方法入组的患者以治疗前血β-HCG≤6 000 m U/ml为标准,对2012年5月至2016年5月邢台市第三医院收治的12例CSP患者进行回顾性的分析。首先给予药物治疗,1周后复查血β-HCG,降低时在超声引导下清宫,必要时给予宫腔压迫球囊止血。观察药物不良反应发生率、急诊手术率(药物治疗过程中和清宫术中)、球囊压迫率、出血量、住院天数、β-HCG下降至正常时间、阴道流血时间、月经复潮时间。结果 8.3%(1/12)的患者用药后因肝功异常行腹腔镜下CSP病灶切除+剖宫产瘢痕修补术。16.7%(2/12)的患者药物治疗2个疗程,8.3%(1/12)的患者清宫术后宫腔压迫球囊止血。清宫术中出血量30～180 ml,75%(9/12)的患者住院时间≤10 d,25%的患者(3/12)住院时间>10 d。术后血β-HCG降至正常的时间为2～4周,术后阴道出血持续时间10～20 d,月经复潮时间30～55 d。治疗过程中无急诊手术发生。患者治疗前、清宫术前、清宫术后血β-HCG平均水平呈不断下降趋势,差异有统计学意义(P<0.05)。结论以血β-HCG值为6 000 m U/ml为临界值,甲氨蝶呤联合超声引导下清宫术+球囊压迫治疗CSP效果确切,风险低,值得推广。.

Objective To investigate the clinical significance of the levels of serum human chorionic gonadotropinbeta(β-HCG) in treatment of scar pregnancy due to uterine-incision delivery in early gestation.Methods The clinical data about 12 patients with cesarean scar pregnancy(CSP) who were diagnosed and treated in our hospital from May 2012 to May2016 were retrospectively analyzed,with taking the serum levels of β-HCG 6,000 mU/ml as criteria.All the patients were treated by methotrexate(MTX) firstly,then ultrasound-guided suction curettage was performed when β-HCG levels were decreased,and uterine cavity compression saccule hemostasis was conducted if necessary.The incidence rate of drug side effect,emergency operation rate,saccule compression rate,bleeding volume and length of staying in hospital,the time of β-HCG reaching to normal levels,vaginal bleeding lasting days and the time after menstruation were observed.Results The 8.3%(1/12) of patients with CSP were treated by laparoscopic lesion excision + caesarean scar neoplasty,and 16.7%(2/12) of patients were treated by pharmacotherapy for two treatment courses,and 8.3%(1/12) of patients were treated by uterine cavity compression saccule hemostasis after complete curettage of uterine cavity,with the bleeding volume being 30-180 ml during the operation.Moreover 75%(9/12) of patients were hospitalized for ≤10 days,and 25%(3/12) of patients were hospitalized for > 10 days.The time for β-HCG decreasing to normal levels was 2 ～ 4 weeks.After operation,vaginal bleeding lasted for 10～20 days,and the time of menstruation recovery was 30-55 days.No patient underwent emergency operation.The average levels of β-HCG were decreased before treatment,before operation and after operation,and the differences were statistically significant(P<0.05).Conclusion Taking β-HCG 6,000 mU/ml as critical value,the therapeutic effects of methotrexate combined with ultrasound-guided suction curettage and uterine cavity compression saccule hemostasis on CSP are satisfactory,with lower risk,therefor,it is worthy of promotion in clinical practice..

Medienart:	E-Artikel

Erscheinungsjahr:	2019-07-26 2019
Erschienen:	2019-07-26

Enthalten in:	Zur Gesamtaufnahme - year:2019
Enthalten in:	He bei yi yao - (2019), 14 vom: 26. Juli, Seite 2109-2112 Original Letters: Enthalten in 河北医药 (DE-600)2994672-4 (DE-600)2994672-4 河北省石家庄市

Reihe:	China Academic Journals (CAJ), E, 医药卫生科技 = Medicine & Public Health

Sprache:	Chinesisch

Weiterer Titel:	The clinical significance of the levels of serum human chorionic gonadotropin-beta in treatment of cesarean scar pregnancy due to uterine-incision delivery in early gestation

Beteiligte Personen:	张志革 [VerfasserIn] 高敏 [Sonstige Person] 马琳 [Sonstige Person] 韩越 [Sonstige Person]

Links:	oversea.cnki.net [lizenzpflichtig]

Themen:	产科学 剖宫产 医药、卫生 医药卫生科技 妇产科学 妊娠 手术后并发症 河北省邢台市第三医院生殖医学科 清宫术 甲氨蝶呤 高危 Cesarean section Curettage Gynecology and Obstetrics High-risk Medicine & Public Health Methotrexate Postoperative complications Pregnancy

Anmerkungen:	Author info:ZHANG Zhige;GAO Min;MA Lin;Department of Reproductive Medicine,The Third Hospital of Xingtai Cuty

Förderinstitution / Projekttitel:

PPN (Katalog-ID):	CAJ635660261