高强度聚焦超声治疗剖宫产瘢痕部位妊娠的效果分析  

Analysis of therapeutic effect of high-intensity focused ultrasound on women with cesarean scar pregnancy

作　　者：严凤[1] 李全香[1] 魏杏茹 付琳琳 胡美丽[1] 陈伟静 YAN Feng;LI Quan-xiang;WEI Xing-ru;FU Lin-lin;HU Mei-li;CHEN Wei-jing(Department of Gynecology,Baoding Maternal and Child Health Hospital,Hebei Province,Baoding 071000,China)

机构地区：[1]河北省保定市妇幼保健院妇科

出　　处：《河北医科大学学报》2019年第12期1413-1416,共4页Journal of Hebei Medical University

基　　金：保定市科学技术研究与发展指导计划(18ZF273)

摘　　要：目的对比观察高强度聚焦超声(high-intensity focused ultrasound,HIFU)和子宫动脉栓塞(uterineartery embolization,UAE)2种方法治疗Ⅱ型剖宫产部位瘢痕妊娠(cesarean scar pregnancyⅡtype,CSPⅡ)者的效果及安全性。方法选择收治的CSPⅡ者142例,依据术前处理方式不同分为HIFU组(n=96例)和UAE组(n=46例),预处理后均行宫腹腔镜切除妊娠病灶,评价其疗效及安全性。结果HIFU组住院时间和治疗费用均少于UAE组(P<0.05)。HIFU组与UAE组术后5周月经恢复正常率和术后4周血人绒毛膜促性腺激素(β-human chorionic gonadotrophin,β-HCG)恢复正常率差异均有统计学意义(P<0.05)。HIFU组与UAE组术中出血量、治疗有效率、血β-HCG恢复率和近期并发症发生率差异均无统计学意义(P>0.05)。结论HIFU预处理联合宫腹腔镜切除妊娠病灶对CSPⅡ型者治疗安全有效,尤其对于有再生育要求的妇女,选择这种方法治疗比UAE更好。Objective To compare the efficacy and safety between high-intensity focused ultrasound(HIFU)treatment and uterineartery embolization(UAE)in treatment of patients with cesarean scar pregnancy Ⅱ type(CSPⅡ).Methods One forty-two CSPⅡ cases diagnosed and treated at our hospital were retrospectively analyzed.Based on different production of preoperative management,142 patients with CSPⅡ were divided into two groups:the HIFU group(n=96 patients)and the UAE group(n=46 patients).The patients in the HIFU group received the treatment with HIFU combined with hysteroscopic removal of pregnancy lesions.The patients in the UAE group received the treatment with combination of UAE andsuction curettage.The efficacy and safety were evaluated by the observed indexes.Results The time of hospital stay and the treatment costs in the HIFU group were less than those in the UAE group(P<0.05).There were significantly statistic differences between two groups in the normal menstrual function recovery rate at 5 weeks after operation and the β-human chorionic gonadotrophin(β-HCG)recovery rate at 4 weeks after operation(P<0.05).Additionally,there were no significantly statistic differences between two groups in the intraoperative blood loss,the effective rate,the blood β-HCG recoveryrate and the recent complication rate(P>0.05).Conclusion HIFU pretreatment combined with laparoscopy is safe and effective in the treatment of CSPⅡ,especially for women with reproductive requirements.

关 键 词：瘢痕妊娠 剖宫产术 高强度聚焦超声 

分 类 号：R713.8[医药卫生—妇产科学]