腹腔镜下瘢痕妊娠物清除术联合子宫动脉栓塞术在Ⅲ型瘢痕妊娠治疗中的应用  

The application of laparoscopic resection combined with pre-operative uterine artery embolization for TypeⅢcesarean scar pregnancy

作　　者：李惠欣 刘梦雨 周璘[1] 王迎春[1] 栾婷 周晓美[1] 李星[1] 贡震 LI Hui-xin;LIU Meng-yu;ZHOU Lin;WANG Ying-chun;LUAN Ting;ZHOU Xiao-mei;LI Xing;GONG Zhen(Department of Gynecology,Women's Hospital of Nanjing Medical Inirersily(Nanjing Maternity and Child Health Care Hospital),Nanjing 210004,Jiangsu,China;不详)

机构地区：[1]南京医科大学附属妇产医院(南京市妇幼保健院)妇科,江苏南京210004 [2]南京医科大学附属肿瘤医院(江苏省肿瘤医院)妇放科,江苏南京210029

出　　处：《广东医学》2021年第11期1316-1319,共4页Guangdong Medical Journal

基　　金：江苏省“六大人才高峰”高层次人才选拔培养资助项目(WSW-086)。

摘　　要：目的探讨腹腔镜下瘢痕妊娠物清除术(LaRCSP)联合子宫动脉栓塞术(UAE)在Ⅲ型剖宫产术后子宫瘢痕妊娠(CSP)患者治疗中的临床价值。方法回顾性分析收治的Ⅲ型CSP患者,其中接受LaRCSP联合术前UAE治疗的患者为观察组(n=17),仅接受LaRCSP治疗的患者为对照组(n=12)。比较两组患者术中出血量、手术时间,中转子宫切除或膀胱损伤发生率,住院时间、治愈率等指标。结果两组患者均未见有中转子宫切除或膀胱损伤发生。两组患者住院时间[(8.2±1.0)d vs.(8.2±1.1)d]及治愈情况(17/17 vs.12/12)等差异无统计学意义(P>0.05)。但手术时间[(1.3±0.2)h vs.(1.7±0.3)h]、术中出血量[(64.9±7.3)mL vs.(107.5±34.5)mL]观察组均显著低于对照组(P<0.05)。结论LaRCSP联合术前UAE在治疗Ⅲ型CSP中疗效确切,且可显著降低手术时间、术中出血量,具有潜在的临床推广应用价值。Objective To investigate the clinical value of laparoscopic resection(LaRCSP)combined with pre-operative uterine artery embolization(UAE)in the treatment of TypeⅢcesarean scar pregnancy.Methods A retrospective analysis was conducted on TypeⅢCSP patients treated in our department from January 2016 to December 2020,among which patients accepted LaRCSP plus pre-operative UAE were considered as observation group and patients accepted LaRCSP alone were taken into control group.These patients were followed up,and the cure rate,incidence of bladder injury,operation time,intraoperative blood loss,length of stay,and etc.were compared between the two groups.Results A total of 29 patients with TypeⅢCSP were enrolled,among which 17 in observation group and 12 in control group.There was no statistically significant difference in the length of stay(8.2±1.0 days vs.8.2±1.1 days)or the cure rate(17/17 vs.12/12)between the two groups.No hysterectomy or bladder injury were found in either group.The average operation time and intraoperative blood loss in observation group were significantly lower than those in control group(1.3±0.2 hr vs.1.7±0.3 hr,64.9±7.3 mL vs.107.5±34.5 mL,P<0.05).Conclusion LaRCSP combined with UAE has a definite effect on the treatment of TypeⅢCSP,and can significantly reduce the operation time and intraoperative blood loss.

关 键 词：Ⅲ型剖宫产术后子宫瘢痕妊娠 腹腔镜下瘢痕妊娠物清除术 子宫动脉栓塞术 

分 类 号：R713.8[医药卫生—妇产科学] R714.2[医药卫生—临床医学]