| Objective: Cesarean section scar pregnancy refers to a special type of ectopic pregnancy caused by the embryo implantation in the uterine scar of the previous cesarean section.Through the analysis of this research take the uterine artery embolization in joint operation,qing intramuscular Methotrexate(Methotrexate,MTX)and qing mifepristone combined misoprostol drugs joint surgery qing three different treatment the curative effect of patients with cesarean scar pregnancy,expect to improve the curative effect of cesarean scar pregnancy.Methods: From January 2015 to January 2017 in our hospital for treatment of the clinical data of 90 patients with cesarean scar pregnancy were retrospectively analyzed,according to patients' treatment,it can be divided into group A(28 cases)and group B(33 cases)and group C(29 cases),A group of patients taking joint uterine artery embolization in the treatment of qing dynasty palace,group B patients take intramuscular injection MTX combined treatment of qing dynasty palace,C group of patients using mifepristone and misoprostol drug combination for the treatment of qing dynasty palace,comparison of three groups of patients with clinical data,clinical treatment,clinical treatment effect and the incidence of adverse reactions after treatment.Results: Through the comparison of three groups of patients with clinical data,results show that the three groups of patients age,pregnancy time,production time and pregnancy sac diameter,the number of gestational weeks,and ultrasonic clinical data classification such as differences in the comparison of no statistical significance(P > 0.05),three sets of data are comparable.By comparing clinical indexes of three groups of patients,found that A group of patients with blood loss,recovery time menstruation,blood HCG dropped to normal time and length of hospital stay(75.81 + 15.59)respectively mL,(80.44-16.98)d,(20.03-5.17)d and d(25.78 + 4.86),B group of patients with blood loss,recovery time menstruation,blood HCG dropped to normal time and length of hospital stay(62.11 + 13.54)respectively mL,(57.73-12.26)d,d(16.31-4.49)and(18.01 + 3.37)d,C group of patients with blood loss,recovery time menstruation,blood HCG dropped to normal time and length of hospital stay(97.74 + 19.94)respectively mL,(95.51-18.83)d,d(28.87-4.72)and(131.34 + 5.09)d.B group of patients with blood loss,recovery time menstruation,blood HCG dropped to normal time and hospital stay were significantly lower than that of group A and group C,the difference was statistically significant(P < 0.05),and A set of recovery time of menstrual blood HCG,dropped to normal time and hospital stay were lower than that of group C(P < 0.05).From the perspective of three groups of patients in the hospital expenses,group A and group B and C group of patients in hospital cost respectively(7372.45 + 1056.22)yuan,(3559.82-841.56)and $(1573.48 + 5.1.89),group B and group C in patients of the cost of hospitalization were significantly lower than that of group A(P < 0.05),and the hospitalization expenses of patients with group C was lower than that in group B(P < 0.05).Through comparing the treatment effects of three groups of patients,the results showed that the treatment of patients with group A total effective rate was 92.86%,B group of patients with treatment the total effective rate was 93.94%,group C in the treatment of patients with the total effective rate was 48.28%,total effective rate of three groups of patients compared with the difference was statistically significant(P < 0.05),the therapeutic effect of group A and group B patients were significantly higher than that of group C(P < 0.05),but in group A and group B compared the therapeutic effect of differences of no statistical significance(P > 0.05).From the results of three groups of patients safety,only 1 case in group B patients appeared adverse reaction,the incidence of adverse reactions was 3.03%,within the group A total of 6 cases with adverse reactions such as nausea and vomiting,abdominal pain,the incidence of adverse reactions was 21.43%,A total of 13 patients appeared in group C adverse reactions such as abdominal pain,liver damage and loss of white blood cells,the incidence of adverse reactions was 44.83%,the incidence of adverse reactions of group B patients was lower than that in group A,21.43% and 44.83% of the group C(P < 0.05),The incidence of adverse reactions in group A was significantly lower than that in group C(P < 0.05).Of three groups of patients with ovarian function compared with the difference was statistically significant(P < 0.05),A group of patients with ovarian function index were significantly different from those of group B and C group(P < 0.05),but group B and C group of patients with ovarian function index difference compared with no statistical significance(P > 0.05).Conclusion: Caesarean scar pregnancy is a special type of ectopic pregnancy,which includes conservative treatment and surgical treatment,but its therapeutic effect is not satisfactory.Cesarean scar pregnancy after intramuscular injection MTX qing dynasty palace not only retained the integrity of the uterus,and retain the function of its birth,is an economic,safe and fast recovery treatment,can shorten the hospitalization time of patients,at the same time,less blood loss,low incidence of adverse reaction rate,menstrual recovery fast and decreased blood HCG fast,etc.,should be widely used in the treatment of cesarean scar pregnancy. |
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