子宫动脉栓塞术联合宫腔镜手术治疗外生型瘢痕妊娠的疗效观察  

Effect of Uterine Artery Embolization combined with Hysteroscopy in the Treatment of Ectogenic Scar Pregnancy

作　　者：陈静平[1] 陆媛媛[1] 韦任姬[1] 刘丽娟[1] 韦木兰 CHEN Jing-ping;LU Yuan-yuan;WEI Ren-ji(Guigang People's Hospital,guigang,guangxi,537100,China)

机构地区：[1]贵港市人民医院,广西贵港537100

出　　处：《医学临床研究》2019年第12期2317-2319,2322,共4页Journal of Clinical Research

摘　　要：【目的】探讨子宫动脉栓塞术(UAE)联合宫腔镜手术治疗外生型剖宫产术后子宫瘢痕妊娠(CSP)的疗效及安全性。【方法】收集2015年3月至2018年12月在本院确诊外生型CSP的92例患者的临床资料,按照治疗方式分为清宫术组(对照组,n=42)与UAE联合宫腔镜手术组(观察组,n=50)。记录两组术中出血量、肛门首次排气时间、住院时间、包块完全吸收时间、术后人绒毛促性腺激素(HCG)转阴时间及月经恢复时间,统计手术并发症发生率,比较两组术后不同时间疼痛视觉模拟评分(VAS)及世界卫生组织生存质量测定量表(WHOQOL-100)评分。【结果】观察组术中出血量显著少于对照组,肛门首次排气时间、住院时间、术后HCG转阴时间、包块完全吸收时间、月经恢复时间均短于对照组,其差异均有统计学意义(P<0.05)。观察组总并发症发生率、术后不同时间点VAS评分均显著低于对照组;生活质量评分显著高于对照组,其差异均有统计学意义(P<0.05)。【结论】UAE联合宫腔镜手术治疗外生型CSP可减少患者术中出血,缩短术后康复时间,降低并发症发生率,其安全性高,且可减轻患者术后疼痛,提高患者生活质量,值得临床推广应用。【Objective】To investigate the efficacy and safety of uterine artery embolization(UAE)combined with hysteroscopy in the treatment of scar pregnancy(CSP)after cesarean section.【Methods】The clinical data of 92 patients with exogenous CSP diagnosed in our hospital from March 2015 to December 2018 were collected.According to the treatment,they were divided into two groups:uterine curettage operation group(control group,n=42)and UAE combined with hysteroscopy operation group(observation group,n=50).The intraoperative bleeding volume,the time of first anal exhaust,the time of hospitalization,the time of complete absorption of the mass,the time of conversion of HCG and the time of menstrual recovery were recorded.The incidence of postoperative complications was counted.The visual analogue score(VAS)and the World Health Organization Quality of life scale(WHOQOL-100)were compared between the two groups.【Results】The amount of bleeding in the observation group was significantly less than that in the control group.The time of the first anal exhaust,the time of hospitalization,the time of hCG turning to negative,the time of complete absorption of the mass and the time of menstrual recovery were all shorter than those in the control group(P<0.05).The total complication rate and VAS score at different time points in the observation group were significantly lower than those in the control group,and the quality of life score was significantly higher than that in the control group(P<0.05).【Conclusion】UAE combined with hysteroscopic surgery for exogenous CSP can reduce intraoperative bleeding,shorten postoperative recovery time,reduce the incidence of complications,and has high safety,and can reduce postoperative pain,improve the quality of life of patients,which is worthy of clinical application.

关 键 词：妊娠并发症/外科学 子宫动脉栓塞术 宫腔镜检查 

分 类 号：R714.25[医药卫生—妇产科学]