双侧子宫动脉栓塞后清宫术与阴式子宫瘢痕妊娠病灶清除联合子宫修补术对患者生活质量的影响  

Effect of Bilateral Uterine Artery Embolization Followed by Uterine Clearance and Negative Cesarean Scar Pregnancy Lesion Removal Combined with Uterine Repair on Patients' Quality of Life

作　　者：裴雷 田德宁 刘金娥 PEI Lei;TIAN Dening;LIU Jin'e(Department of Gynecology,Binzhou Central Hospital,Binzhou,Shandong Province,251700 China;Department of Orthopedics,Binzhou Central Hospital,Binzhou,Shandong Province,251700 China)

机构地区：[1]滨州市中心医院妇科,山东滨州251700 [2]滨州市中心医院骨科,山东滨州251700

出　　处：《中外医疗》2022年第36期68-72,共5页China & Foreign Medical Treatment

摘　　要：目的 对比分析在子宫瘢痕妊娠(cesarean scar pregnancy,CSP)治疗中,采取双侧子宫动脉栓塞后清宫术与阴式子宫瘢痕妊娠病灶清除联合子宫修补术干预的临床效果。方法 方便选取滨州市中心医院2019年7月—2021年6月收治的84例子宫瘢痕妊娠患者为研究对象,依据随机数表法将患者按照1∶1的比例纳入两组,对照组(42例)采取双侧子宫动脉栓塞后清宫术干预,观察组(42例)采取阴式子宫瘢痕妊娠病灶清除联合子宫修补术干预。比较两组临床指标、术后恢复指标、并发症发生率及生活质量。结果 对照组术中出血量(19.87±6.55)mL少于观察组(81.56±15.44)mL,对照组手术时间(18.86±5.64)min短于观察组(41.23±13.55)min,差异有统计学意义(t=23.837、9.878,P<0.05);观察组术后阴道出血时间、住院时间均短于对照组,差异有统计学意义(t=5.231、10.201,P<0.05)。术后24 h观察组血β-绒毛膜促性腺激素(β-HCG)水平低于对照组,且血β-HCG值恢复时间、抗生素使用时间及月经复潮时间均短于对照组,差异有统计学意义(t=34.437、5.383、11.437、14.437,P<0.05)。两组术后并发症比较,差异无统计学意义(χ^(2)=0.000,P>0.05)。观察组术后3个月各维度简明生活质量评估量表(SF-36)评分高于对照组,差异有统计学意义(t=4.336、5.258、5.585、4.934、4.205、4.786、4.591、4.395,P<0.05)。结论 在CSP治疗中,采取双侧子宫动脉栓塞后清宫术或阴式子宫瘢痕妊娠病灶清除联合子宫修补术干预均可取得较好的临床效果,具有较高的应用安全性,但修补术可进一步缩短患者预后恢复时间,提升其生活质量,促进患者康复。Objective To compare and analyze the clinical effects of bilateral uterine artery embolization and clearance of cesarean scar pregnancy(CSP)with negative uterine scar pregnancy combined with uterine repair in the treatment of CSP.Methods Eighty-four patients with cesarean scar pregnancy admitted to Binzhou Central Hospital from July 2019 to June 2021 were conveniently selected for the study.Based on the random number table method,eightyfour patients were included in two groups according to the ratio of 1/1.The control group(forty-two patients)was treated with bilateral uterine artery embolization followed by uterine debridement,while the observation group(forty-two patients)was treated with negative cesarean scar pregnancy lesion removal combined with uterine repair.The clinical indexes,postoperative recovery indexes,complication rate and quality of life of the two groups were compared.Results The amount of intraoperative bleeding in the control group(19.87±6.55)mL was less than that in the observation group(81.56±15.44)mL,and the operation time was shorter in the control group(18.86±5.64)min than that in the observation group(41.23±13.55)min,the difference was statistically significant(t=23.837,9.878,P<0.05);the postoperative vaginal bleeding and hospitalization time in the observation group shorter lower than those in the control group,the difference was statistically significant(t=5.231,10.201,P<0.05).The bloodβ-human chorionic gonadotrophin(β-HCG)level in the observation group was lower than that in the control group 24 h after surgery,and the time to restore bloodβ-HCG value,antibiotic use and menstrual resumption were shorter than those in the control group,the difference was statistically significant(t=34.437,5.383,11.437,14.437,P<0.05).There was no statistically significant difference in the comparison of postoperative complications between the two groups(χ^(2)=0.000,P>0.05).The MOS Item Short from Health Survey(SF-36)scores of each dimension were higher in the observation group than in the contro

关 键 词：双侧子宫动脉栓塞 清宫术 阴式子宫瘢痕妊娠病灶清除 子宫修补术 生活质量 

分 类 号：R5[医药卫生—内科学]