病灶切除术联合UAB或UAE治疗Ⅲ型子宫瘢痕妊娠效果比较  

Comparison on the curative effect of the focus excision combined with uterine artery blockade or uterine artery embolization for treating patients with type III cesarean scar pregnancy

作　　者：刘春宇 蔡喜梅 韩芳喜 LIU Chunyu;CAI Ximei;HAN Fangxi(Wenchang City Qingling Maternal and Child Health Care Hospital,Wenchang,Hainan Province,571300)

机构地区：[1]海南省文昌市庆龄妇幼保健院,571300

出　　处：《中国计划生育学杂志》2023年第5期1135-1138,1142,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨子宫动脉阻断术(UAB)或子宫动脉栓塞术(UAE)联合瘢痕妊娠病灶切除术(FER)治疗Ⅲ型子宫瘢痕妊娠(CSP)效果。方法:回顾性分析2019年1月-2021年1月本院收治的III型CSP患者92例临床资料,根据手术方式分为UAB组39例和UAE组53例。UAB组实施UAB联合FER术,UAE组实施UAE联合FER术。比较两组手术时间、术中出血量、术后宫腔引流量、住院时间、住院费用和术后阴道停止出血时间、体温恢复时间、术后第1天β-人绒毛膜促性腺激素(β-hCG)差值和月经恢复时间;记录两组术后并发症发生情况。结果:UAB组术中手术时间(33.0±2.5 min)、出血量(82.2±13.6 ml)、术后宫腔引流量(19.9±3.1 ml)、住院时间(6.0±1.6 d)和住院费用(1.09±0.47万元)均低于UAE组(39.8±2.8 min、119.5±20.2 ml、25.0±5.0 ml、8.7±2.1 d、1.44±0.52万元)(P<0.05);两组术后阴道停止流血时间、体温恢复时间、术后第1天β-hCG差值和月经恢复时间比较无差异(P>0.05);术后并发症发生率UAB组(18.0%)与UAE组(22.6%)无差异(P>0.05)。结论:与UAE联合FER相比,UAB联合FER可降低Ⅲ型CSP患者术中出血量和术后子宫引流量,降低住院时间和费用,并发症少,疗效确切。Objective:To explore the curative effect of the focus excision(FER)combined with uterine artery blockade(UAB)and uterine artery embolization(UAE)for treating patients with type III cesarean scar pregnancy(CSP).Meth-ods:A retrospective analysis was performed on 92 patients with type III CSP between January 2019 and January 2021.According to different surgical methods,these patients were divided into group A(39 cases with UAB combined with FER)and group B(53 cases with UAE combined with FER).The operation time,the intraoperative blood loss,the postoperative intrauterine drainage volume,the hospitalization time,the hospitalization cost,the stopping time of postoperative vaginal bleeding,the recovery time of temperature to normal,the difference value ofβhuman chorionic gonadotropin(βHCG),in the 1st day after surgery,and the menstruation recovery time of the patients were compared between the two groups.The occurrence of the postoperative complications of the patients in both groups was recorded.Results:The operative time(33.0±2.5 min),the blood loss(82.2±13.6 ml),the postoperative uterine drainage vol-ume(19.9±3.1 ml),the time of hospital stay(6.0±1.6 d),and the hospitalization cost(10.9±4.7 thousand yuan)of the patients in A group were all significantly lower than those(39.8±2.8 min,119.5±20.2 ml,25.0±5.0 ml,8.7±2.1 d,and 14.4±5.2 thousand yuan)of the patients in group B(P<0.05).There were no significant differences in the stopping time of postoperative vaginal bleeding,the recovery time of temperature to normal,the difference value ofβ-HCG in the 1st day after surgery,and the menstruation recovery time of the patients between the two groups(P>0.05).There was no significant difference in the incidence of postoperative complications(18.0%vs.22.6%)of the patients between the two groups(P>0.05).Conclusion:Compared with those of UAE combined with FER for treating the patients with type III CSP,UAB combined with FER for treating the patients can reduce their intraopera-tive blood loss,their postoperative int

关 键 词：Ⅲ型子宫瘢痕妊娠 瘢痕妊娠病灶切除术 子宫动脉阻断术 子宫动脉栓塞术 治疗效果 

分 类 号：R714.22[医药卫生—妇产科学]