阴式病灶清除联合子宫瘢痕修补术对子宫瘢痕妊娠患者临床疗效及预后影响  

Clinical efficacy and prognosis of vaginal lesion clearance combined with uterine scar repair for treating women with type Ⅱ cesarean scar pregnancy

作　　者：王海英[1] WANG Haiying(The Fifth People's Hospital of Chengdu City,Sichuan Province,611130)

机构地区：[1]四川省成都市第五人民医院,611130

出　　处：《中国计划生育学杂志》2019年第4期465-468,共4页Chinese Journal of Family Planning

摘　　要：目的:观察阴式病灶清除联合子宫瘢痕修补术用于治疗Ⅱ、Ⅲ型剖宫产子宫疤痕妊娠的临床疗效及预后。方法:2013年6月—2015年6月本院治疗的150例Ⅱ、Ⅲ型子宫疤痕妊娠患者为研究对象,随机数字表法分为对照组(n=75)和观察组(n=75),观察组予以阴式病灶清除联合子宫瘢痕修补术,对照组予以子宫动脉栓塞联合清宫术治疗,统计手术时间、术中出血量、住院时间、月经恢复时间和治疗费用,监测患者治疗前后血清绒毛膜促性腺水平(β-hCG)。结果:观察组术中出血量和治疗费用少于对照组,住院时间、月经恢复时间和β-hCG水平恢复正常时间短于对照组,术后5d、10d血清β-hCG水平低于对照组(均P=0.000);两组手术均成功,术中及术后均未出现不良反应及并发症;随访术后3年观察组子宫瘢痕妊娠复发率(1.3%)低于对照组(12.0%),正常妊娠率(56.0%)高于对照组(38.7%)(P=0.009、0.034)。结论:阴式病灶清除联合子宫瘢痕修补术应用于Ⅱ、Ⅲ型剖宫产子宫疤痕妊娠治疗,具有医源性创伤小,术后恢复快,医疗成本低等特点,安全性和有效性高,且有助于保留患者生育功能,降低瘢痕妊娠复发风险,具有较好的临床应用价值。Objective:To observe the clinical efficacy and prognosis of vaginal lesion clearance combined with uterine scar repair for treating women with type II cesarean scar pregnancy.Methods:150 women with type II uterine scar pregnancy were selected as research objects from June 2013 to June 2015,and all of them were divided into control group (n=75) and obervation group (n=75) according to the random number table method.Women in obervation group were treated by vaginal lesion clearance combined with uterine scar repair,while women in control group were treated by uterine artery embolization combined with uterine curettage.The operation time,intraoperative bleeding volume,hospitalization time,menstrual recovery time,and treatment cost were compared between the two groups.Serum beta hCG levels of all women were monitored before and after treatment.Results:There was no significant different in time of serum beta hCG recovered to normal level between the two groups (t=0.934,P =0.152),but the amount of bleeding and treatment cost of women in obervation group were significant less than those of women in control group (t=6.314,42.517;P =0.000,0.000),and the hospital stay time,menstrual recovery time,and the time of beta hCG recovered to normal level of women in obervation group were significant shorter than those of women in control group (t=5.931,6.372,15.633;P =0.000,0.000,0.000).The serum levels of beta hCG of women in obervation group were significant lower than those of women in control group at 5 and 10 days after operation (t=12.853,9.462;P =0.000,0.000).The women in both groups were successfully operated,and no any woman had adverse reaction and complication during and after operation.The recurrence rate of uterine scar pregnancy of women in obervation group(1.3%)was significant lower than that of women in control group(12.0%),and the normal pregnancy rate of women(56.0%)was significant higher than that of women in control group(38.7%)(χ^2=6.857,4.520;P =0.009,0.034).Conclusion:Vaginal lesion clearance combined with

关 键 词：子宫瘢痕妊娠 阴式病灶清除 子宫瘢痕修补 临床疗效 预后 

分 类 号：R713.8[医药卫生—妇产科学]