子宫动脉栓塞术在剖宫产后子宫瘢痕部位妊娠中的应用效果  

Application effect of uterine artery embolization in cesarean scar pregnancy patients

作　　者：张文莉 张忠明[1] 冯彩霞[2] 王蕊 ZHANG Wen-li;ZHANG Zhong-ming;FENG Cai-xia;WANG Rui(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Xi′an Jiaotong University,Shaanxi Province,Xi′an710061,China;Department of Obstetrics and Gynecology,the First Hospital of Yulin City,Shaanxi Province,Yulin719000,China)

机构地区：[1]西安交通大学第一附属医院妇产科,陕西西安710061 [2]陕西省榆林市第一医院妇产科,陕西榆林719000

出　　处：《中国当代医药》2020年第11期116-119,共4页China Modern Medicine

摘　　要：目的探讨子宫动脉栓塞术在剖宫产后子宫瘢痕部位妊娠中的应用效果。方法回顾性分析2014年1月~2017年12月西安交通大学第一附属医院收治的66例瘢痕妊娠患者的一般资料,按照治疗方法的不同,将患者分为介入栓塞组(31例)和宫腹腔镜组(35例)。介入栓塞组患者采用子宫动脉栓塞+宫腔镜下清宫术治疗方法,宫腹腔镜组患者采用宫腔镜联合腹腔镜下瘢痕妊娠病灶切除修补术治疗方法。比较两组患者的治疗和预后相关参数。结果介入栓塞组患者的术中出血量少于宫腹腔镜组,住院时间短于宫腹腔镜组,差异均有统计学意义(P<0.05);两组患者的手术时间和治疗成功率比较,差异无统计学意义(P>0.05);介入栓塞组患者的治疗后阴道流血时间和血清人绒毛膜促性腺激素(β-HCG)值恢复正常时间短于宫腹腔镜组,差异均有统计学意义(P<0.05);两组患者治疗后的月经情况比较,差异无统计学意义(P>0.05)。结论子宫动脉栓塞术治疗瘢痕妊娠的效果肯定,与宫腹腔镜联合手术方式相比,其住院时间更短,术后阴道流血时间和血清β-HCG值恢复正常时间也更短。Objective To investigate the application effect of uterine artery embolization cesarean scar pregnancy patients. Methods The general clinical data of cesarean scar pregnancy patients trested in the First Affiliated Hospital of Xi’an Jiaotong University from January 2014 to December 2017 were retrospectively analyzed. Patients were divided into interventional embolization group(31 cases) and laparoscopy group(35 cases) according to different treatment methods. Patients in the interventional embolization group were treated with uterine artery embolization and hysteroscopic hysterectomy, while patients in the hysteroscopy group were treated with hysteroscopy combined with laparoscopic resection and repair of scar pregnancy lesions. Treatment and prognostic parameters were compared between the two groups. Results The intraoperative blood loss in the interventional embolization group was less than that in the laparoscopic group, and the length of stay was shorter than that in the laparoscopic group, with statistically significant differences(P<0.05). There were no significant differences in the operation time and treatment success rate between the two groups(P>0.05). The time of vaginal bleeding and serum human chorionic gonadotropin(β-HCG) in the interventional embolization group after treatment was shorter than that in the laparoscopy group, with statistically significant difference(P<0.05). There was no significant difference in the menstrual status between the two groups after treatment(P>0.05). Conclusion The efficacy of uterine artery embolization in the treatment of scar pregnancy is confirmed. Compared with the combined approach of laparoscopy, the duration of hospital stay is shorter, the time of postoperative vaginal bleeding and the time for serum β-HCG to return to normal is also shorter.

关 键 词：瘢痕妊娠 子宫动脉栓塞 腹腔镜 宫腔镜 清宫术 

分 类 号：R714.461[医药卫生—妇产科学]