明胶海绵微粒行子宫动脉栓塞治疗子宫瘢痕妊娠疗效分析  

An analysis of the efficacy of uterine artery embolization with gelatin sponge particles against uterine scar pregnancy

作　　者：胡银笑 关燕鸣[1] 梁雪莹[1] HU Yinxiao;GUAN Yanming;LIANG Xueying(Department of Obstetrics and Gynecology,Boai Hospital of Zhongshan,Guangdong,Zhongshan 528400,China)

机构地区：[1]广东省中山市博爱医院妇产科,广东中山528400

出　　处：《中国医药科学》2020年第12期82-84,165,共4页China Medicine And Pharmacy

基　　金：广东省中山市医学科研项目(2018A020400)。

摘　　要：目的探究明胶海绵微粒行子宫动脉栓塞治疗子宫瘢痕妊娠的疗效。方法选取2018年4月1日~2019年10月30日的子宫瘢痕妊娠患者60例,行子宫动脉栓塞术治疗,随机分成对照组和观察组,各30例。对照组选用直径310μm明胶海绵微粒,观察组应用直径710μm明胶海绵微粒。术后随访12个月,包括卵巢储备功能[抗苗勒氏管激素(AMH)、窦卵泡数(AFC)],阴道彩色超声监测患者子宫内膜厚度,内膜下血管血流变化,月经量及月经周期的变化,宫腔镜检查内膜活检(细胞增殖指数)。结果术后1、3个月时,观察组的AMH水平及AFC个数均高于对照组,差异有统计学意义(P<0.05)。观察组的子宫内膜厚度大于对照组,差异有统计学意义(P<0.05)。观察组的内膜下血流的分级较对照组高,差异有统计学意义(P<0.05)。观察组的月经量及月经周期的改善程度优于对照组,差异有统计学意义(P<0.05)。术后6、12个月时,观察组的细胞增殖指数LI高于对照组,差异有统计学意义(P<0.05)。观察组与对照组的AMH水平及AFC个数、子宫内膜厚度、内膜下血管血流分级的比较,差异均无统计学意义(P>0.05)。观察组与对照组的月经量及月经周期的改善水平基本相当,差异均无统计学意义(P>0.05)。结论行子宫动脉栓塞治疗子宫瘢痕妊娠的治疗选用直径710μm颗粒栓塞剂,既可增加临床成功率,又可减少破坏卵巢组织内正常的血管网。Objective To investigate the efficacy of uterine artery embolization(UAE)with gelatin sponge particles(GSPs)against uterine scar pregnancy.Methods 60 patients with uterine scar pregnancy from April 1,2018 to October 30,2019 were selected and treated by UAE.They were randomly divided into the control group(n=30)and the observation group(n=30).For the control group,GSPs with a diameter of 310μm were selected and used,and for the observation group,GSPs with a diameter of 710μm were applied.The follow-up for 12 m after operation covered ovarian reserve functions(anti-Müllerian hormone shortened as AMH,and antral follicle count shortened as AFC),vaginal color monitoring of endometrial thickness,changes in blood flow of subintimal vessels,changes in menstrual amount and menstrual cycle,and endometrial biopsy(cell proliferation index)by hysteroscopy.Results At 1 m and 3 m after operation,the AMH level and AFC number in the observation group were both superior to those in the control group,and the differences were statistically significant(P<0.05).The endometrial thickness in the observation group was larger than that in the control group,and the difference was statistically significant(P<0.05).The level of subintimal blood flow in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The improvement of menstrual amount and menstrual cycle in the observation group was better than that in the control group,and the difference was statistically significant(P<0.05).At 6 m and 12 m after operation,the cell proliferation index LI of the observation group was higher than that of the control group,with statistically significant difference(P<0.05).There was no statistically significant difference in AMH level,AFC number,endometrial thickness and level of blood flow of subintimal vessels between the observation group and the control group(P>0.05).The improvement level of menstrual amount and menstrual cycle in the observation group and the control group was basi

关 键 词：明胶海绵微粒 子宫动脉栓塞 子宫瘢痕妊娠 宫腔镜 

分 类 号：R714.2[医药卫生—妇产科学]