剖宫产术后疤痕妊娠患者经米非司酮联合B超监护下清宫术治疗的疗效分析  

Analysis of the curative effect of mifepristone combined with b-ultrasound in the treatment of scar pregnancy after cesarean section

作　　者：孙向花 张幸辉 付秀梅 张晓辉[4] Sun Xiang-hua;Zhang Xing-hui;Fu Xiu-mei;Zhang Xiao-hui(Department of Obstetrics and Gynecology,Luoyang Mudan Maternity Hospital,Luoyang 4710001,Henan,China;Department of Obstetrics and Gynecology,Luoyang Dongdu Hospital,Luoyang 4710001,Henan,China;Department of Obstetrics and Gynecology,Luoyang Anhe Hospital,Luoyang 4710001,Henan,China;Department of Obstetrics and Gynecology,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 4710001,Henan,China)

机构地区：[1]洛阳牡丹妇产医院妇产科,河南洛阳471000 [2]洛阳东都医院妇产科,河南洛阳471002 [3]洛阳安和医院妇产科,河南洛阳4711003 [4]河南科技大学第一附属医院妇产科,河南洛阳4710004

出　　处：《四川生理科学杂志》2022年第2期204-206,203,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:探讨剖宫产术后疤痕妊娠患者经米非司酮联合B超监护下清宫术治疗效果。方法:选取2019年7月~2020年6月我院98例剖宫产术后疤痕妊娠患者,参照随机数字表法分为常规组(n=49)和研究组(n=49)。常规组治疗方案为开腹子宫疤痕妊娠病灶切除术,研究组实施米非司酮与B超监护下清宫术联合治疗,比较两组手术相关指标(手术时间、术中出血量)、术后恢复情况[月经恢复时间、术后住院时间、β-人绒毛膜促性腺激素(β-HCG)恢复时间]、术后并发症发生率及术前、术后3d血清性激素[雌激素(E2)、孕酮(P)、血清促卵泡素(FSH)、黄体生成素(LH)]水平。结果:研究组手术时间、术中出血量低于常规组(P<0.05);研究组β-HCG降至正常时间、月经恢复时间及术后住院时间较常规组短(P<0.05);术后3d,研究组血清LH、P水平较常规组低,E2、FSH水平较常规组高(P<0.05);研究组并发症发生率4.08%较常规组16.33%低(P<0.05)。结论:米非司酮、清宫术(B超监护下)联合治疗剖宫产术后疤痕妊娠,可缩短手术时间,减少患者术中出血量,促进术后恢复,在稳定性激素水平、减少并发症发生方面具有积极意义。Objective:To investigate the effect of mifepristone combined with B-ultrasound in the treatment of scar pregnancy after cesarean section.Methods:From July 2019 to June 2020,98 patients with scar pregnancy after cesarean section in our hospital were selected and divided into conventional group(n=49)and study group(n=49)according to random number table method.The treatment plan of the conventional group was laparotomy for uterine scar and pregnancy lesion resection,while the study group was combined with mifepristone and uterine clearance under b-ultrasound monitoring.Compared the two groups of indicators related to the operation,operation time,intraoperative blood loss,postoperative recovery[menstrual recovery time,hospital stay,postoperative beta human chorionic gonadotropin(beta HCG)recovery time],the incidence of postoperative complications,preoperative and postoperative 3 d serum sex hormones estrogen(E2)and progesterone(P),serum follicle stimulating hormone(FSH),corpus luteum formation Level of LH.Results:The operative time and intraoperative blood loss in the study group were lower than those in the conventional group(P<0.05).The time ofβ-HCG descending to normal,menstrual recovery time and postoperative hospital stay in the study group were shorter than those in the conventional group(P<0.05).Three days after surgery,the serum LH and P levels in the study group were lower than those in the conventional group,while E2 and FSH levels were higher than those in the conventional group(P<0.05).The complication rate of the study group was 4.08%lower than that of the conventional group 16.33%(P<0.05).Conclusion:The combined treatment of mifepristone and uterine clearance(under the supervision of B-ultrasound)for scar pregnancy after cesarean section can shorten the operation time,reduce the amount of intraoperative blood loss,promote postoperative recovery,and has positive significance in stabilizing the level of sex hormones and reducing the incidence of complications.

关 键 词：剖宫产 疤痕妊娠 米非司酮 B超监护下清宫术 开腹子宫疤痕妊娠病灶切除术 性激素水平 

分 类 号：R71[医药卫生—妇产科学]