超声监测下清宫术与子宫动脉栓塞后清宫术治疗剖宫产术后子宫瘢痕妊娠的疗效观察  

Observation on the therapeutic effect of ultrasound monitoring curettage and curettage after uterine artery embolization on uterine scar pregnancy after cesarean section

作　　者：侯翠[1] 唐晓霞[1] 张平[1] 曾艳花[1] 杨志宏[1] HOU Cui;TANG Xiao-xia;ZHANG Ping;ZENG Yan-hua;YANG Zhi-hong(Department of Gynaecology,Shenzhen Longgang District Central Hospital,Shenzhen 518116,Guangdong,CHINA)

机构地区：[1]深圳市龙岗中心医院妇科,广东深圳518116

出　　处：《海南医学》2018年第18期2611-2613,共3页Hainan Medical Journal

摘　　要：目的对比超声监测下清宫术与子宫动脉栓塞后清宫术治疗剖宫产术后子宫瘢痕妊娠(CSP)的疗效,以期为临床治疗方案的选择提供依据。方法选择深圳市龙岗中心医院妇科2015年1月至2018年5月期间收治的78例CSP患者为研究对象,根据随机数表法分为观察组与对照组,每组39例,对照组患者在超声监测下行清宫术治疗,观察组患者则应用子宫动脉栓塞后行清宫术治疗,比较两组患者围手术期出血量、血人绒毛膜促性腺激素(β-HCG)转阴时间、住院时间、疗效及并发症发生情况。结果观察组患者的围手术期出血量、血β-HCG转阴时间及住院时间分别为(11.4±4.6) mL、(17.9±5.3) d、(7.7±2.6) d,明显少于对照组的(38.5±8.1) mL、(21.4±6.7) d、(9.8±3.4) d,差异均有统计学意义(P<0.05);观察组患者的治疗成功率为97.44%,明显高于对照组的87.18%,不良反应发生率为7.69%,明显低于对照组的28.21%,差异均有统计学意义(P<0.05)。结论子宫动脉栓塞后清宫术治疗剖宫产术后子宫瘢痕妊娠,与超声监测下清宫术比较,具有更高的成功率及安全性。Objective To explore the curative effect of general ultrasound monitoring curettage and uterine curettage after uterine artery embolization（UAE） for cesarean scar pregnancy（CSP）, and to provide basis for the selection of clinical treatment. Methods A total of 78 cases of CSP patients admitted to the Department of Gynaecology in Shenzhen Longgang District Central Hospital from January 2015 to May 2018 were selected in this research. According to the random number table method, they were divided into an observation group and a control group, with 39 cases in each group. The control group was treated with curettage under ultrasound monitoring, and the observation group was treated with the uterine curettage after UAE. The two groups of patients were compared for differences in the amount of perioperative bleeding, the time for blood beta human chorionic gonadotropin（β-hCG） conversion to negative, length of hospital stay, curative effects and complications. Results In the observation group, the amount of perioperative bleeding, the time for blood β-hCG conversion to negative, length of hospital stay was（11.4±4.6） mL,（17.9±5.3） days and（7.7±2.6） days, respectively, significantly less than the corresponding（38.5±8.1） mL,（21.4± 6.7） days and（9.8±3.4） days in the control group（P〈0.05）. The treatment success rate of the observation group was 97.44%, significantly higher than 87.18% for the control group; and the incidence of adverse reactions in the observation group was 7.69%, significantly lower than 28.21% in the control group; both differences were statistically significant（P〈0.05）. Conclusion Curettage for CSP after uterine artery embolization has higher success rate and safety than only curettage under ultrasound monitoring.

关 键 词：超声监测 清宫术 子宫动脉栓塞术 剖宫产术后子宫瘢痕妊娠 疗效 

分 类 号：R714.2[医药卫生—妇产科学]