子宫动脉栓塞联合不同处理方案治疗剖宫产瘢痕妊娠的临床疗效  

Clinical efficacy of uterine arterial embolism combined with multiple treatment regimens on cesarean scar pregnancy

作　　者：郝聿韬 穆永旭[1] 闫瑞强[1] 张磊[1] HAO Yutao;MU Yongxu;YAN Ruiqiang;ZHANG Lei(Medical College,Inner Mongolia University of Science&Technology,Baotou,Inner,014010,China)

机构地区：[1]内蒙古科技大学包头医学院,内蒙古包头014010

出　　处：《当代医学》2023年第1期43-47,共5页Contemporary Medicine

基　　金：内蒙古自治区科技计划项目(201502080)。

摘　　要：目的探讨采用子宫动脉栓塞(UAE)联合不同处理方案治疗剖宫产瘢痕妊娠的临床疗效。方法选取2018年9月至2021年9月本院收治的107例剖宫产瘢痕妊娠患者作为研究对象,根据治疗方案不同分为对照组(n=24)、观察组A(n=32)、观察组B(n=21)与观察组C(n=30)。对照组采用子宫动脉栓塞治疗,观察组A采用子宫动脉栓塞+清宫术治疗,观察组B组采用子宫动脉栓塞+中药(消妊祛瘀组方加减)治疗;观察组C采用子宫动脉栓塞+清宫+中药(消妊祛瘀组方加减)治疗,比较4组治疗前后卵巢功能[雌二醇(E_(2))、黄体生成素(LH)、促卵泡激素(FSH)、抗缪勒氏管激素(AMH)]、住院时间、人绒毛膜促性腺激素-β(β-hCG)水平恢复正常时间、月经恢复正常时间及并发症发生情况。结果4组E2、LH、FSH、AMH水平比较差异无统计学意义。观察组A、观察组B、观察组C住院时间和β-hCG水平恢复正常时间及月经恢复正常时间均短于对照组,且观察组C短于观察组A和观察组B,观察组A短于观察组B,差异有统计学意义(P<0.05)。各组均未见严重肝肾功能损害及卵巢坏死等重度不良反应,仅个别患者出现一过性肝功能异常且在3周内恢复正常。腹痛发生率最高,为22.43%。4组不良反应发生率比较差异无统计学意义;但观察组C不良反应发生率低于对照组,差异有统计学意义(P<0.05);观察组A、观察组B与对照组及观察组A与观察组B不良反应发生率比较差异无统计学意义。结论UAE联合中西医结合治疗效果显著,可缩短患者住院时间,促进机体更快恢复,不良反应少,安全性高,值得临床推广应用。Objective To explore the clinical efficacy of uterine arterial embolism(UAE)combined with multiple treatment regimens on cesarean scar pregnancy.Methods 107 patients with cesarean scar pregnancy admitted to our hospital from September 2018 to September 2021 were selected as the research subjects,and they were divided into control group(n=24),observation group A(n=32),observation group B(n=21)and observation group C(n=30)according to different treatment schemes.The control group was treated with uterine arterial embolism,the observation group A was treated with uterine arterial embolism+uterine curettage,and the observation group B was treated with uterine arterial embolism+Traditional Chinese Medicine(modified formula for eliminating pregnancy and removing blood stasis),the observation group C was treated with uterine arterial embolism+uterine curettage+Traditional Chinese Medicine(modified formula for eliminating pregnancy and removing blood stasis).The ovarian function(estradiol[E_(2)],luteotropic hormone[LH],follicle-stimulating hormone[FSH],anti-Müllerian hormone[AMH]),hospitalization time,normal time of human chorionic gonadotropin-β(β-hCG)level,recovery time of menstruation and complications were compared among the four groups before and after treatment.Results There was no significant difference in the levels of E2,LH,FSH and AMH among the four groups.The hospitalization time,the normal time ofβ-hCG level and the recovery time of menstruation in the observation group A,the observation group B and the observation group C were shorter than those in the control group,and the observation group C was shorter than the observation group A observation group B,the observation group A was shorter than the observation group B,the difference was statistically significant(P<0.05).There were no severe adverse reactions such as severe liver and kidney function damage and ovarian necrosis in each group,only individual patients had transient abnormal liver function and returned to normal within 3 weeks.The highest inci

关 键 词：剖宫产瘢痕妊娠 子宫动脉栓塞 清宫术 中药 

分 类 号：R713.8[医药卫生—妇产科学]