基于随机行走模型分析不同年龄段瘢痕妊娠患者经子宫动脉栓塞术治疗的疗效  

Efficacy of transcatheter uterine artery embolization in scar pregnancy patients of different ages based on random walk model

作　　者：黄永平[1] 缪军[1] 李虎[1] Huang Yongping;Miao Jun;Li Hu(Department of Interventional,Jiangyin Hospital of Traditional Chinese Medicine,Jiangyin 214400,China)

机构地区：[1]江阴市中医院介入科,江阴214400

出　　处：《中国医师杂志》2023年第4期510-515,共6页Journal of Chinese Physician

摘　　要：目的探讨不同年龄段瘢痕妊娠(CSP)患者经子宫动脉栓塞术(UAE)治疗的疗效及安全性。方法选择2016年7月至2020年7月江阴市中医院收治的120例CSP患者为研究对象,根据年龄分为观察组(≤35岁,75例)和对照组(>35岁,45例),收集所有患者临床资料并随访6个月,对比两组患者的临床观察指标、手术疗效、视觉模拟量表(VAS)评分、卵巢恢复情况、术后并发症和不良反应、术后6个月生活质量评分。采用随机行走模型评价两组患者卵巢功能改善情况。结果观察组术中出血量、手术时间、术后β绒毛膜促性腺激素(β-HCG)值、β-HCG值转阴时间和月经恢复时间明显少于对照组(均P<0.05)。观察组总有效率为96.00%,对照组总有效率为91.11%,差异无统计学意义(P>0.05)。两组患者术前、术后48、72 h的VAS评分差异无统计学意义(均P>0.05),观察组术后12、24 h的VAS评分明显高于对照组(均P<0.05)。观察组患者治疗后血清卵泡刺激素(FSH)、雌二醇(E_(2))、睾酮素(T)、黄体生成素(LH)水平均优于对照组(均P<0.05)。两组患者二次清宫、大出血、切除子宫、切口感染、阴道出血、阴道血肿发生率差异均无统计学意义(均P>0.05),但观察组患者并发症总发生率明显小于对照组患者(P<0.05)。两组患者腹泻、发热、恶心呕吐、腹痛等不良反应经对症治疗后均明显好转,两组患者不良反应发生率比较差异无统计学意义(P>0.05)。两组患者术后6个月生存质量评分比较差异无统计学意义(P>0.05)。随机行走模型评估结果显示,观察组的改善系数为0.1476、0.1359、0.1802、0.2063,对照组分别为0.1422、0.0989、0.1524、0.1974。结论不同年龄段CSP患者采用UAE治疗,临床疗效未见明显差异,术后不易发生并发症,预后较好。Objective To explore the efficacy and safety of cesarean scar pregnancy(CSP)in different ages treated by uterine artery embolization(UAE).Methods 120 patients with CSP admitted to Jiangyin Hospital of Traditional Chinese Medicine from July 2016 to July 2019 were selected as the research objects.They were divided into observation group(≤35 years,75 cases)and control group(>35 years,45 cases)according to age.Clinical data of all patients were collected and followed up for 6 months.The clinical observation indicators,surgical efficacy,Visual Analogue Scale(VAS)score,ovarian recovery,postoperative complications and adverse reactions,and quality of life score at 6 months after surgery were compared between the two groups.A random walk model was used to evaluate the improvement of ovarian function in the two groups.Results In the observation group,the blood loss,operation time,postoperativeβ-human chorionic gonadotropin(β-HCG)value,β-HCG value turning negative and menstrual recovery time were significantly less than those in the control group(all P<0.05).The total effective rate was above 90%in the two groups,and no significant difference was observed(96.00%vs 91.11%,P>0.05).There was no statistical significance in VAS score of the two groups before surgery,48 h and 72 h after surgery(all P>0.05),and VAS score of the observation group at 12 h and 24 h after surgery were significantly higher than those of the control group(all P<0.05).The levels of serum follicle stimulating hormone(FSH),estradiol(E_(2)),testosterone(T)and luteinizing hormone(LH)in observation group were better than those in control group after treatment(all P<0.05).There was no significant difference in the incidence of secondary uterine clearance,massive bleeding,hysterectomy,incision infection,vaginal bleeding and vaginal hematoma between the two groups(all P>0.05),but the total incidence of complications in observation group was significantly lower than that in control group(P<0.05).Diarrhea,fever,nausea and vomiting,abdominal pain and other ad

关 键 词：子宫动脉栓塞术 瘢痕妊娠 年龄 

分 类 号：R714.22[医药卫生—妇产科学]