剖宫产术后Ⅲ型子宫瘢痕妊娠不同处理方式效果分析  

Efficacy analysis of different treatment methods for treating typeⅢcesarean scar pregnancy

作　　者：蹇梦婵 贺细菊[3] 范丽 JIAN Mengchan;HE Xiju;FAN Li(Postgraduate Training Base1 of Hubei Medicine College of Jinzhou Medical University, Shiyan,Hubei Province, 442000;The People's Hospital of Shiyan City;Hubei Medicine College)

机构地区：[1]锦州医科大学湖北医药学院研究生培养基地,十堰442000 [2]十堰市人民医院 [3]湖北医药学院

出　　处：《中国计划生育学杂志》2020年第5期756-759,共4页Chinese Journal of Family Planning

基　　金：湖北省教育厅重点项目基金资助(D20192103)。

摘　　要：目的:比较剖宫产术后瘢痕妊娠(CSP)Ⅲ型不同处理方式的治疗效果。方法:回顾性收集本院90例Ⅲ型CSP患者临床资料,分别为子宫动脉栓塞术(A组)、米非司酮联合甲氨蝶呤胎囊注射术(B组)、米非司酮配伍米索前列醇片(C组)不同治疗后再行宫腔镜下清宫术。结果:术后A组HCG恢复时间(12.9±2.1d)少于B组(19.4±3.7d)及C组(24.5±2.7 d)(F=12.104,P=0.008),术中出血量(81.9±7.0ml)少于B组(119.2±10.5ml)和C组(135.0±13.3 ml)(F=20.068,P=0.002);住院天数B组(15.4±4.2d)长于A组和(7.3±1.9d)C组(8.5±2.2 d)(F=6.586,P=0.031),住院费用A组(13932.5±1527.3元)高于B组(6864.7±981.4元)和C组(5510.8±717.6元)(F=48.305,P=0.000)。结论:子宫动脉栓塞术联合宫腔镜下清宫术治疗Ⅲ型CSP成功率高,清除病灶安全可靠,并发症少,但住院费用相对较高。Objective:To compare the clinical efficacy of different methods for treating patients withⅢtype cesarean scar pregnancy(CSP).Methods:The clinical data of 90 patients withⅢtype CSP were collected retrospectively.These patients were all treated by hysteroscopic curettage and were divided into three groups based on different pretreatments.The patients in group A were given uterine artery embolization as pretreatments,the patients in group B were given methotrexate(MTX)fetal sac injection combined with mifepristone as pretreatments,and the patients in group C were given mifepristone combined with misoprostol tablets as pretreatments.Results:Postoperative recovery time of HCG of patients in group A was 12.9±2.1d,which was significant less than that(19.4±3.7d)of patients in group B and that(24.5±2.7d)of patients in group C(F=12.104,P=0.008),and intraoperative blood loss of patients in group A was 81.9±7.0ml,which was also significant less than that(119.2±10.5ml)of patients in group B and that(135.0±13.3 ml)of patients in group C(F=20.068,P=0.002).The time of hospitalization of patients in group B was 15.4±4.2d,which was significant longer than that(7.3±1.9d)of patients in group A and that(8.5±2.2d)of patients in group C(F=6.586,P=0.031).The hospitalization expenses of patients in group A was 13932.5±1527.3 Yuan,which was significant higher than that(6864.7±981.4 Yuan)of patients in group B and that(5510.8±717.6 Yuan)of patients in group C(F=48.305,P=0.000).Conclusion:Uterine artery embolization combined with hysteroscopic curettage for treating patients with III type CSP has high success rate,which can remove the lesion safely and reliably,but the hospitalization expenses is higher.

关 键 词：Ⅲ型剖宫产术后瘢痕妊娠 子宫动脉栓塞术 甲氨蝶呤胎囊注射术 米非司酮 米索前列醇 治疗效果 

分 类 号：R714.22[医药卫生—妇产科学]