Objective To evaluate the efficacy and safety of ultrasound-guided gestational sac injection of lauromacrogol and methotrexate (MTX) for cesarean scar pregnancy (CSP). Methods Sixty-nine women with CSP were randomly divided into the study group (36 cases) and the control group (33 cases). In study group, the lauromacrogol and MTX (50mg) were injected into gestation sac guided by ultrasound, and in the control group the MTX (50mg) was injected. The curettage was performed under ultrasonic monitoring in two groups 24h after injection. The volume of intraoperative bleeding, the proportion of Foley catheter balloon placement, the recovery time of blood β -HCG level, the thickness of the uterine scar wall, the time of menstruation recovery, the adverse reactions were documented and compared between two groups. Results The volume of intraoperative bleeding and the proportion of Foley catheter balloon placement and the incidence of adverse reactions in study group were lower, the recovery time of blood β -HCG and the recovery time of menstruation were shorter than those in the control group(all P＜0.05). There was no significant difference in the thickness of the uterine scar wall 3 months after the operation between two groups (P ＞0.05). Conclusion Ultrasound-guided gestational sac injection of lauromacrogol combined with methotrexate for CSP is safe and less invasive with less adverse reactions, it can be applied in primary hospitals.%目的探讨超声引导下孕囊注射聚桂醇及甲氨蝶呤(MTX)治疗剖宫产瘢痕妊娠(CSP)的有效性和安全性.方法选取CSP患者69例,按随机数字表法分为观察组36例和对照组33例.观察组超声引导下孕囊注射聚桂醇加MTX 50mg,对照组超声引导下孕囊注射MTX 50mg,24h后两组均行超声监视下清宫术.比较两组患者术中出血量、Foley尿管球囊放置比例、血人绒毛膜促性腺激素(β-HCG)恢复正常时间、术后3个月瘢痕处宫壁厚度、月经恢复时间和不良反应.结果观察组术中出血量、Foley尿管球囊放置比例、血β-HCG恢复正常时间、月经恢复时间和不良反应发生率均少于对照组,差异均有统计学意义(均P＜0.05);术后3个月两组瘢痕处宫壁厚度比较差异无统计学意义(P＞0.05).结论超声引导下聚桂醇联合MTX孕囊注射治疗CSP,创伤小,安全性好,不良反应少,适合基层医院推广使用.
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