内生型(Ⅰ、Ⅱ)剖宫产瘢痕部位妊娠两种治疗方法的疗效观察  

Observation of the therapeutic effect of endogenous(Ⅰ,Ⅱ)cesarean scar pregnancy

作　　者：姚新敬 李丽岩 孙琳[1] 张晓霞[1] YAO Xinjing;LI Liyan;SUN Lin;ZHANG Xiaoxia(Department of Obstetrics and Gynecology,First Hospital of Jilin University,Changchun,130000,China)

机构地区：[1]长春吉林大学第一医院,130000

出　　处：《中国妇产科临床杂志》2020年第3期245-247,共3页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的对比分析内生型(Ⅰ、Ⅱ)剖宫产瘢痕部位妊娠(CSP)两种治疗方式的临床疗效。方法回顾性分析2016年1月至2019年1月就诊于吉林大学第一医院的176例内生型CSP患者的临床资料,将采用超声监视下清宫术的129例内生型CSP患者设为清宫组;采用子宫动脉栓塞(UAE)联合宫腔镜手术的47例内生型CSP患者设为栓塞组。分别对两种治疗方式的术中出血量、血清β-人绒毛膜促性腺激素(β-hCG)转阴时间、术后阴道流血时间、住院时间、花费及成功率进行对比分析。结果对于治疗内生Ⅰ型CSP患者,清宫组在住院时间及花费上明显低于栓塞组,差异有统计学意义(P<0.05),对于治疗内生Ⅱ型CSP患者,栓塞组成功率明显高于清宫组,差异有统计学意义(P<0.05)。结论对于治疗Ⅰ型且妊娠囊<5 cm的患者,采用超声监视下清宫治疗更具优势;对于Ⅱ型或妊娠囊≥5 cm的患者,采用UAE联合宫腔镜手术能够有效提高治疗成功率,降低二次治疗率。Objective To compare and analyze the clinical effects of two treatment methods for endogenous(Ⅰ,Ⅱ)cesarean scar pregnancy(CSP).Methods The clinical data of 176 patients with endogenous CSP who visited the First Hospital of Jilin University from January 2016 to January 2019 were retrospectively analyzed.129 patients with endogenous CSP who underwent curettage under ultrasound monitoring were set as curettage group.47 patients with endogenous CSP who underwent uterine artery embolism(UAE)combined with hysteroscopy were set as embolism group.The intraoperative blood loss,serumβ-human chorionic gonadotropin(β-hCG)negative conversion time,postoperative vaginal bleeding time,success rate,hospitalization time and hospitalization cost of the two treatment methods were compared and analyzed respectively.Results For patients with endogenous typeⅠCSP,the hospitalization time and cost of the curettage group were significantly lower than those of the embolization group,with statistically difference.For patients with endogenous typeⅡCSP,the embolic component power was significantly higher than that of the curettage group,with statistically difference.Conclusions For patients with endogenic typeⅠor gestational sac<5 cm,the therapeutic effect of ultrasound monitoring is more advantageous.Uterine artery embolization combined with hysteroscopy can effectively improve the success rate and reduce the secondary treatment rate for patients with endogenous typeⅡCSP.

关 键 词：分型 剖宫产瘢痕部位妊娠 子宫动脉栓塞术 超声 清宫术 

分 类 号：R714.22[医药卫生—妇产科学]