Comparison of three treatment strategies for cesarean scar pregnancy
Comparison of three treatment strategies for cesarean scar pregnancy
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剖宫产疤痕妊娠三种治疗策略的比较
DOI：
10.1007/s00404-017-4426-5
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发表时间：
2017-08-01
影响因子：
2.6
通讯作者：
Jia, Xuemei
中科院分区：
文献类型：
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作者：
Liu, Guangquan;Wu, Jiacong;Jia, Xuemei
为探讨剖宫产术后瘢痕妊娠的最佳治疗方法，将86例剖宫产术后瘢痕妊娠患者按治疗方法分为3组。比较A组（UAE + MTX + D&C组）、B组（UAE + MTX）、C组（D & C组）的hCG下降率、术中出血量及手术成功率。A组成功率最高（97.5%），B组成功率最低（76%），C组成功率最低（63.15%）。A组hCG下降幅度最大（86.62%，44.0-99.97%），B组（67.83%，18.0-98.03%）和C组（68.21%，27.0-93.24%）差异有统计学意义。术中出血量A组（44.881，5-200 ml）低于C组（224.737，10-1000 ml）。A组最佳D&C时机取决于hCG下降率，UAE + MTX局部注射后hCG下降35%可作为D&C的指标，UAE + MTX局部注射+D&C是CSP患者的最佳治疗策略。UAE和局部MTX注射后hCG下降35%可作为D&C的推荐指标。
To explore the optimal treatment for cesarean scar pregnancy.In total, 86 women diagnosed with a cesarean scar pregnancy were divided into three groups according to treatment. The human chorionic gonadotrophin (hCG) decline percentage, intraoperative blood loss and success rate were analyzed in Group A [combination of uterine arterial embolization (UAE), local methotrexate (MTX) injection and dilation & curettage (D&C)], Group B (combination of UAE and local MTX injection) and Group C (D&C). Then, the best treatment was carefully analyzed, and recommendations were provided.The success rate was highest in Group A (97.5%) compared with Group B (76%) and Group C (63.15%). The reduction in hCG was greatest in Group A (86.62%, 44.0-99.97%) compared with group B (67.83%, 18.0-98.03%) and Group C (68.21%, 27.0-93.24%). The intraoperative blood loss was lowest in Group A (44.881, 5-200 ml) compared with Group C (224.737, 10-1000 ml). Additionally, we found that the best time to perform D&C in group A depended on the hCG reduction percentage, and a 35% reduction after UAE and local MTX injection could be used as the indicator to perform D&C.The combination of UAE, local MTX injection and D&C for CSP patients is the optimal treatment strategy. A 35% reduction in hCG after UAE and local MTX injection can be recommended as the indicator to perform D&C.