不同超声分型剖宫产瘢痕部位妊娠治疗方案的选择研究  

Study on the selection of therapeutic schemes for different types of cesarean section scar pregnancy by ultrasound

作　　者：孙寒冰 尤淑艳 孙丹 SUN Hanbing;YOU Shuyan;SUN Dan(Department of Ultrasound,Dalian Maternal and Child Health Hospital,Dalian,Liaoning,116000,China;Department of Gynecology,Dalian Maternal and Child Health Hospital,Dalian,Liaoning,116000,China)

机构地区：[1]大连市妇幼保健院超声科,辽宁大连116000 [2]大连市妇幼保健院妇科,辽宁大连116000

出　　处：《当代医学》2023年第3期57-60,共4页Contemporary Medicine

摘　　要：目的研究不同超声分型剖宫产瘢痕部位妊娠的治疗方案及效果。方法选取2017年6月至2020年6月本院收治的200例剖宫产瘢痕部位妊娠患者作为研究对象,根据超声分型分为包块富血流型、包块乏血流型、孕囊富血流型、孕囊乏血流型,各50例,将不同分型剖宫产瘢痕部位妊娠患者平均分为两组,分别为包块富血流型方案一组、包块富血流型方案二组,包块乏血流型方案一组、包块乏血流型方案二组,孕囊富血流型方案一组、孕囊富血流型方案二组,孕囊乏血流型方案一组、孕囊乏血流型方案二组,每组25例。方案一组:超声引导下刮宫,方案二组:子宫动脉栓塞+甲氨蝶呤,比较4种不同分型患者两种方案的治疗效果。结果包块富血流型方案二组阴道出血量少于包块富血流型方案一组,HCG恢复正常水平时间、住院时间均短于包块富血流型方案一组,治疗成功率高于包块富血流型方案一组,差异有统计学意义(P<0.05)。包块乏血流型方案一组与包块乏血流型方案二组阴道出血量、HCG恢复正常水平时间、治疗成功率及住院时间比较差异无统计学意义。孕囊富血流型方案二组阴道出血量少于孕囊富血流型方案一组,HCG恢复正常水平时间、住院时间均短于孕囊富血流型方案一组,治疗成功率高于孕囊富血流型方案一组,差异有统计学意义(P<0.05)。孕囊乏血流型方案一组与孕囊乏血流型方案二组阴道出血量、HCG恢复正常水平时间、治疗成功率及住院时间比较差异无统计学意义。结论剖宫产瘢痕部位妊娠具有多种分型,针对不同分型选择不同治疗方案,疗效也不尽相同,因此,在实际剖宫产瘢痕部位妊娠临床治疗中,需根据实际超声分型选择最佳治疗方案,以增强治疗效果,提高患者临床受益。Objective To study the therapeutic schemes and effects of different types of cesarean scar pregnancy by ultrasound.Methods A total of 200 pregnant patients with caesarean section scar pregnancy admitted to our hospital from June 2017 to June 2020 were selected as the research subjects,and they were divided into mass rich blood flow type,mass poor blood flow type,pregnancy-sac rich blood type and pregnancy-sac poor blood type according to ultrasonic classification,with 50 cases in each type.The patients with different types of caesarean section scar pregnancy were evenly divided into two groups,with 25 cases in each group,including mass rich blood flow type scheme one group,mass rich blood flow type scheme two group,mass poor blood flow type scheme one group,mass poor blood flow type scheme two group,pregnancy-sac rich blood type Scheme one group,pregnancy-sac rich blood type scheme two group,pregnancy-sac poor blood type scheme one group,pregnancy-sac poor blood type scheme two group.scheme one group:ultrasoundguided curettage;scheme two group:uterine artery embolization+methotrexate,the therapeutic effects of the two schemes were compared among four different types of patients.Results The amount of vaginal bleeding in the mass rich blood flow type scheme two group was less than that in the mass rich blood flow type scheme one group,the recovery time of HCG and the length of hospital stay were shorter than those in the mass rich blood flow type scheme one group,and the success rate of treatment was higher than that in the mass rich blood flow type scheme one group,the differences were statistically significant(P<0.05).There was no significant difference in the amount of vaginal bleeding,the recovery time of HCG,the success rate of treatment and the length of hospital stay between the mass poor blood flow type scheme one group and mass poor blood flow type scheme two group.The amount of vaginal bleeding in the pregnancy-sac rich blood type scheme two group was less than that in the pregnancy-sac rich blood type sc

关 键 词：剖宫产 瘢痕部位妊娠 超声分型 治疗方案 

分 类 号：R714.22[医药卫生—妇产科学]