关键词: 甲氨蝶呤, 剖宫产术, 瘢痕妊娠, 囊胚破坏, 子宫动脉栓塞

Abstract: Objective To analyse the clinical efficacy of methotrexate (MTX) combined with intrauterine embryo sac garrotte injection in the treatment of cesarean scar pregnancy (CSP), and discuss its clinical significance. Methods A total of 77 patients with CSP treated in our hospital during June 2013 to December 2016 were selected in this study. Forty patients treated with embryo sac destruction and methotrexate injection were included in the observation group, while 37 cases treated by uterine artery embolization combined with curettage were used as the control group. The time of vaginal bleeding, the time of postoperative blood level of human chorionic gonadotropin (HCG) returned to the normal level, average hospitalization cost and the curative rate were recorded in two groups. All patients were followed up by the outpatient visit. Results In the observation group, the vaginal bleeding time [(22.1±6.7) days vs. (29.5±10.8) days] and treatment cost [(8 774.2±714.5) yuan vs. (15 258.3±1 084.2) yuan] were less than those of the control group (P＜0.001). There were no significant differences in the recovery time of HCG [(26.4±9.0) days vs. (25.1±10.4) days] and treatment success rate (87.5% vs. 91.9%) between the two groups (P＞0.05). No bleeding or threatened rupture of scar were found in two groups of patients. Conclusion In this study, we take the embryo sac puncture combined with methotrexate injection in the treatment of scar pregnancy. This method has the advantages of low operative difficulty, definite clinical curative effect and low cost

Key words: methotrexate, cesarean section, scar pregnancy, intrauterine injection, uterine artery embolization