Ⅱ型剖宫产术后子宫瘢痕妊娠两种方案疗效比较  

Comparison of the Efficacy of Two Therapeutic Regimens for Type Ⅱ Cesarean Scar Pregnancy

作　　者：陈丹丹 谭开亮[1] 蒋丽[1] 覃锦燊 

机构地区：[1]广西壮族自治区妇幼保健院,广西南宁530022 [2]中国科技开发院广西分院,广西南宁530022

出　　处：《大众科技》2022年第12期99-102,共4页Popular Science & Technology

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20170769)。

摘　　要：目的:比较Ⅱ型剖宫产术后子宫瘢痕妊娠两种方案疗效,探讨Ⅱ型剖宫产术后子宫瘢痕妊娠最佳治疗方案。方法:回顾性分析2019年1月至2020年12月在广西壮族自治区妇幼保健院妇科收治的45例Ⅱ型剖宫产术后子宫瘢痕妊娠患者的临床治疗,根据所采用的治疗方式不同分为两组:A组采用B超引导下清宫术+宫腔球囊压迫(n=27例),B组采用子宫动脉栓塞术+B超引导下清宫术+宫腔球囊压迫(n=18例),观察比较两者术中出血量、术后第1天血清β-HCG下降比率、住院天数、住院费用、术后疼痛情况。结果:两组患者术中出血量及术后第1天血清β-HCG下降比率比较,差异无统计学意义(P>0.05)。A组住院天数及住院费用均明显少于B组(P<0.05)。B组疼痛发生率明显高于A组(P=0.02)。结论:B超引导下清宫术+宫腔球囊压迫及子宫动脉栓塞术+B超引导下清宫术+宫腔球囊压迫均为有效治疗方案,但对于血HCG<30000mIU/mL且孕囊最大直径<3.0 cm的Ⅱ型CSP患者,可考虑行B超引导下清宫术+宫腔球囊压迫的治疗方案。Objective: To compare the efficacy of two therapeutic regimens for the patients with type Ⅱ cesarean scar pregnancy(CSP),and to explore the best therapeutic regimens for the patients with type Ⅱ CSP. Methods: The clinical data of 45 patients with CSP who were admitted to Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region between 2019 to 2020 were retrospectivedly analyzed. These patients were divided into 2 groups according to the treatment menthods. Group A was treated with B-ultrasound-guided uterine debridement + uterine balloon compression(n=27 cases), and group B was treated with uterine artery embolization +B-ultrasound-guided uterine debridement + uterine balloon compression(n=18 cases). Intraoperative blood loss, the decrease rate of serum β-HCG on the first day after surgery, length of stay, hospitalization cost and postoperative pain were observed and compared between the two groups. Results: There was no significant difference in intraoperative blood loss and the decline rate of blood β-HCG on the first postoperative day between the 2 groups(P>0.05). The length of hospital stay and hospitalization expenses in group A were significantly less than those in group B(P>0.05). The incidence of pain in group B was significantly higher than that in group A(P=0.02). Conclusion:B-ultrasound-guided uterine debridement + uterine balloon compression and uterine artery embolization + B-ultrasound-guided uterine debridement + uterine balloon compression are effective treatment options. However, the treatment scheme of B-ultrasound-guided uterine debridement + uterine balloon compression can be considered for type Ⅱ CSP patients with blood HCG < 30000 mIU/mL and maximum diameter of gestational sac <3.0 cm.

关 键 词：剖宫产瘢妊娠 清宫术 子宫动脉栓塞术 

分 类 号：R714[医药卫生—妇产科学]