注射甲氨喋呤后腹腔镜辅助清宫术治疗子宫切口妊娠的护理

余发丽，周凌云，陈培

（陕西省宝鸡市中心医院，陕西 宝鸡，721008）

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摘要：

目的 探讨注射甲氨喋呤（MTX）后行腹腔镜辅助清宫术治疗子宫切口妊娠的不良反应及相应的护理措施。方法 选取在我院治疗的子宫切口妊娠患者47例作为研究对象，实施阴道超声引导下孕囊内注射MTX后根据血HCG值及孕囊包块大小情况于3~10 d内行腹腔镜辅助清宫术，观察患者注射MTX后及术后的不良反应发生情况，并针对不良反应进行护理。结果 注射MTX后的不良反应以出血和消化道反应的发生率较高，骨髓抑制、疼痛次之，发热的发生率相对较低；术后不良反应以恶心呕吐、阴道出血发生率较高，疼痛次之，感染、皮下气肿和高碳酸血症发生率较低。结论 注药MTX后行腹腔镜辅助清宫术治疗子宫切口妊娠会产生一些药物及术后不良反应，而及时有效的护理措施是保证治疗效果的必 要条件。

关键词：子宫切口妊娠；甲氨喋呤；腹腔镜辅助清宫术；不良反应

中图分类号：R713.4文献标志码：A文章编号：2096-1413(2017)21-0173-02

Nursing of methotrexate injected laparoscopic assisted uterine curettage on cesarean scar pregnancy
YU Fa-li, ZHOU Ling-yun, CHEN Pei
(Baoji Central Hospital, Baoji 721008, China)

ABSTRACT: Objective To investigate the adverse reactions and corresponding nursing measures of methotrexate (MTX) injected laparoscopic assisted uterine curettage on cesarean scar pregnancy. Methods Forty-seven cases of cesarean scar pregnancy patients admitted in our hospital were selected as the research subjects, the fertilized egg was injected MTX under the guidance of vaginal ultrasound, and then the laparoscopic assisted curettage were carried out according to the blood HCG value and gestational sac mass in 3-10 d. The incidences of adverse reactions after MTX injection and operation were observed and nursing for adverse reactions was conducted. Results After the injection of MTX, the higher incidences of adverse reactions were bleeding and gastrointestinal reactions, and then bone marrow suppression and pain, the incidence of fever was relatively low. The higher incidence of postoperative adverse reactions were nausea and vomiting, vaginal bleeding, and the pain, infection, subcutaneous emphysema and hypercapnia with low incidence. Conclusion Complications of drug and surgery can be found during the injection of MTX and after laparoscopic assisted uterine curettage on cesarean scar pregnancy patients, timely nursing measures could guarantee the treatment effect.
KEYWORDS: cesarean scar pregnancy; methotrexate; laparoscopic assisted uterine curettage; adverse reactions

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