双侧子宫动脉栓塞后宫腔镜清宫和单纯宫腔镜下清宫治疗不同类型剖宫产后瘢痕妊娠临床疗效探究  

The clinical effect of hysteroscopic evacuation after bilateral uterine artery embolization and hysteroscopic evacuation in the treatment of different types of scar pregnancy after cesarean section

作　　者：周莹 付宏望 林静[1] Zhou Ying;Fu Hongwang;Lin Jing(The Sixth Affiliated Hospital of Guangzhou Medical University,The People's Hospital of Qingyuan City,Qingyuan,Guangdong 511500)

机构地区：[1]广州医科大学附属第六医院,清远市人民医院,广东清远511500

出　　处：《基层医学论坛》2021年第4期445-446,共2页The Medical Forum

基　　金：2019年度清远市社会发展领域自筹经费科技计划项目立项(190909114568387)。

摘　　要：目的探讨双侧子宫动脉栓塞后宫腔镜清宫和单纯宫腔镜下清宫治疗不同类型剖宫产后瘢痕妊娠(CSP)的临床疗效。方法选择2019年1月—2020年10月清远市人民医院收治的120例CSP患者,按随机数字表法分为对照组(n=60,Ⅰ型30例,Ⅱ型30例)和观察组(n=60,Ⅰ型30例,Ⅱ型30例)。对照组采用单纯宫腔镜下清宫,观察组采用双侧子宫动脉栓塞后宫腔镜清宫。对比2组术中出血量、手术时间、住院天数、血清中β人绒毛膜促性腺激素(β-HCG)降至正常值时间,并统计2组并发症发生情况。结果观察组术中出血量(67.92±33.49)mL,较对照组的(123.74±45.67)mL少;手术时间(19.31±5.27)min、住院天数(11.27±1.22)d、血清β-HCG恢复正常时间(18.26±1.35)d,较对照组的(30.16±4.19)min、(15.78±2.86)d、(23.57±2.43)d短;并发症发生率(5.00%)较对照组(20.00%)低,差异均有统计学意义(P<0.05)。结论双侧子宫动脉栓塞后宫腔镜清宫可缩短不同类型CSP手术时间、血清β-HCG恢复正常时间,减少术中出血量,降低并发症发生率。Objective To investigate the clinical efficacy of hysteroscopic evacuation after bilateral uterine artery embolization and hysteroscopic evacuation in the treatment of different types of post-cesarean scar pregnancy(CSP),in order to improve the prognosis of patients.Methods A total of 120 CSP patients admitted to our hospital from January 2019 to October 2020 were selected and randomly divided into control group(n=60,30 cases of type I,30 cases of type II)and observation group(n=60,30 cases of type I,30 cases of type II).The control group was treated with hysteroscopy alone,and the observation group was treated with bilateral uterine artery embolization.The curative effects of the two groups were compared,including the amount of intraoperative blood loss,operation time,days of hospitalization,and the time forβ-HCG in serum to drop to normal,and the occurrence of complications in the two groups was counted.Results The intraoperative blood loss of the observation group was(67.92±33.49)ml less than that of the control group(123.74±45.67)ml,the operation time was(19.31±5.27)min,the hospital stay was(11.27±1.22)d,and the time for serumβ-HCG to return to normal(18.26±1.35)d shorter than the control group(30.16±4.19)min,(15.78±2.86)d,(23.57±2.43)d,the complication rate(5.00%)is lower than the control group(20.00%),the difference is statistical Academic significance(P<0.05).Conclusion Hysteroscopic uterine evacuation after bilateral uterine artery embolization can shorten the operation time of different types of CSP,the time for serumβ-HCG to return to normal,reduce intraoperative blood loss and reduce the incidence of complications.

关 键 词：剖宫产 瘢痕妊娠 双侧子宫动脉栓塞 宫腔镜清宫 临床疗效 

分 类 号：R71[医药卫生—妇产科学]