The Efficacy and Safety of High-Intensity Focused Ultrasound Combined with Methotrexate in the Treatment of Cesarean Scar Pregnancy
Objective To investigate the efficacy of high-intensity focused ultrasound(HIFU)combined with methotrexate(MTX)in the treatment of cesarean scar pregnancy(CSP)and its impact on the changes in the levels of serum procalcitonin(PCT)and β-human chorionic gonadotropin(β-HCG).Methods The data of 92 CSP patients admitted to Zhoukou City Maternal and Child Health Hospital from January 2021 to January 2023 were retrospectively collected.These patients were divided into a control group and an observation group based on different treatment methods,with 46 patients in each group.The control group was treated with HIFU,while the observation group was treated with methotrexate combined with HIFU.Both groups underwent hysteroscopic curettage and scar repair surgery 2 to 3 days after pretreatment.The efficacy,clinical indexes(time forβ-HCG to return to normal,time for menstruation to return to normal,vaginal bleeding time),ovarian function[luteinizing hormone(LH),estradiol(E2),follicle-stimulating hormone(FSH)],disease-related factors(PCT,β-HCG),and incidence of complications(numbness in hands and feet,pain and distension in the sacrococcygeal region,burning sensation in the treated skin area)were compared between the 2 groups.Results The clinical total effective rate in the observation group(91.30%)was higher than that in the control group(73.91%)(P＜0.05).After treatment,the time for β-HCG to return to normal,time for menstruation to return to normal,and vaginal bleeding time in the observation group were shorter than those in the control group(P＜0.05).There were no statistically significant differences in LH,E2,and FSH between the 2 groups before and after treatment(P＞0.05).Compared with before treatment,the observation group showed a greater reduction in PCT and β-HCG after treatment than the control group(P＜0.05).There was no statistically significant difference in the incidence of complications between the 2 groups(P＞0.05).Conclusion This study suggests that methotrexate combined with HIFU can preserve ovarian function,reduce PCT and β-HCG levels,and promote the recovery without increasing the incidence of complications,demonstrating positive clinical efficacy in the management of CSP patients.
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