Study on effect of ultrasound-guided inguinal injection of methotrexate combined with hysteroscopy on treatment of cesarean scar pregnancy and effect on hCG level
Objective To investigate the clinical efficacy of hysteroscopic surgery combined with intratexial injection of methotrexate(MTX)in the treatment of cicatricial pregnancy and the influence on the level of human chorionic gonado-tropin(β-HCG).Methods A retrospective study of 100 patients with cesarean scar pregnancy(CSP)treated in the First Affiliated Hospital of Zhengzhou University from June 2020 to May 2022 was selected,and 50 patients treated with hysteroscopic surgery were selected as the control group.The observation group was 50 cases treated with hysteroscopic surgery combined with ultrasound-guided methotrexate intrafectum injection.The therapeutic effect,β-HCG level,perioperative indexes(intraoperative blood loss,menstrual recovery time,time of mass disappearance and length of hos-pital stay)and complications were recorded and compared between the two groups.Results The total effective rate of observation group(94.00％)was higher than that of control group(74.00％),and the difference was statistically sig-nificant(P＜0.05).There was no significant difference in β-HCG level between the two groups before treatment(P＞0.05).After 1,3,7 and 14 days of treatment,the β-HCG levels in the observation group were(709.25±68.31)U/L,(420.56±47.25)U/L,(269.94±23.37)U/L and(60.56±5.49)U/L,respectively,which were lower than those in the control group,and the difference was statistically significant(P＜0.05).After treatment,the intraoperative blood loss in the observation group was(42.01±4.16)ml,the menstrual recovery time(33.72±10.3)d,the time of mass disappearance(20.46±2.19)and the length of hospital stay(15.77±1.81)d were lower than those in the control group,and the differences were statistically significant(P＜0.05).The incidence of complications in the observation group was 2.0％,significantly lower than that in the control group(10.0％),and the difference was statistically significant(P＜0.05).Conclusion Ultrasound-guided methotrexate intragestational injection combined with hysteroscopic surgery is effective in the treatment of CSP,which can improve β-HCG level,shorten menstrual re-covery time and hospital stay,reduce intraoperative blood loss,and has high safety.
MethotrexateCaesarean sectionScar pregnancyHysteroscopic surgery
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