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目的对比2种手术方法治疗瘢痕妊娠的多普勒彩超及血清β-人绒毛膜促性腺激素(β-h CG)水平。方法将84例瘢痕妊娠患者随机分为试验组和对照组各42例。试验组给予B型超声引导下靶向注射甲氨蝶呤联合清宫术治疗,对照组给予子宫动脉化疗栓塞联合B型超声引导下清宫术治疗,对比观察2组患者治疗后多普勒彩超及血清β-h CG水平变化。结果试验组患者治疗后血流极丰富和丰富发生率明显低于对照组,而较丰富和点条状/无发生率高于对照组,差异均有统计学意义(P<0.05)。2组患者治疗前血流阻力指数差异无统计学意义(P>0.05);治疗后2组患者血流阻力指数均升高,且试验组升高幅度明显高于对照组,差异有统计学意义(P<0.05)。治疗前2组血清β-h CG水平差异无统计学意义(P>0.05);治疗后2组患者β-h CG水平均降低,且试验组降低幅度明显大于对照组,差异有统计学意义(P<0.05)。结论 B型超声引导下靶向注射甲氨蝶呤联合清宫术治疗瘢痕妊娠对多普勒彩超及血清β-h CG水平的改善程度优于子宫动脉化疗栓塞联合B型超声引导下清宫术治疗。
Objective To compare the two methods of surgical treatment of scar pregnancy by Doppler ultrasound and serum β-human chorionic gonadotropin (β-h CG) levels. Methods Eighty-four patients with scar pregnancy were randomly divided into experimental group and control group with 42 cases each. The experimental group was given B-type ultrasound guided targeted methotrexate combined with curettage, the control group was given uterine artery chemoembolization combined with B-mode ultrasound-guided curettage, comparative observation of two groups after treatment, Doppler ultrasound and serum β-h CG level changes. Results After treatment, the patients with experimental group had significantly lower blood flow rate and richness rate than those in control group, while those with richer and more stripe-like / non-occurrence rate were significantly higher than those in control group (P <0.05). There was no significant difference of blood flow resistance index between the two groups before treatment (P> 0.05). After treatment, the blood flow resistance index of two groups increased, and the increase rate of the experimental group was significantly higher than that of the control group, the difference was statistically significant (P <0.05). There was no significant difference in serum β-h CG levels between the two groups before treatment (P> 0.05). The levels of β-h CG decreased in both groups after treatment, and the decrease in the experimental group was significantly greater than that in the control group P <0.05). Conclusion B-mode ultrasound-guided methotrexate combined with curettage in the treatment of scar pregnancy improved the level of Doppler ultrasound and serum β-h CG better than uterine artery chemoembolization combined with B-mode ultrasound-guided curettage.