高强度聚焦超声与子宫动脉栓塞辅助负压吸宫术治疗剖宫产瘢痕部位妊娠的效果比较  

Comparison on effect of vacuum aspiration assisted by high-intensity focused ultrasound and uterine artery embolization in the treatment of cesarean section scar

作　　者：刘莉[1] 赵可 任杰 Liu Li;Zhao Ke;Ren Jie(Department of Obstetrics and Gynecology,Zhoukou Central Hospital,Zhoukou 466000,China)

机构地区：[1]周口市中心医院妇产科,周口466000

出　　处：《中国实用医刊》2023年第24期24-26,共3页Chinese Journal of Practical Medicine

摘　　要：目的比较高强度聚焦超声与子宫动脉栓塞辅助负压吸宫术治疗剖宫产瘢痕部位妊娠的临床效果。方法抽取2019年8月至2022年8月周口市中心医院收治的剖宫产瘢痕部位妊娠患者90例,均行负压吸宫术治疗,根据辅助治疗方案将其分为A组(行子宫动脉栓塞辅助治疗)和B组(行高强度聚焦超声辅助治疗),每组45例。比较两组临床疗效、安全性及预后情况。结果治疗后,A组总有效率(95.56%,43/45)与B组(97.78%,44/45)比较,差异未见统计学意义(P>0.05)。B组高热、下肢痛、恶心呕吐发生率低于A组,下腹部及腰骶疼痛发生率高于A组,差异有统计学意义(P<0.05)。术后1、3个月,两组血清人绒毛膜促性腺激素转阴率比较,差异未见统计学意义(P>0.05)。术后3、6个月,B组经量降低发生率均低于A组(P均<0.05);术后1年,B组再次妊娠率(42.22%,19/45)高于A组(22.22%,10/45),P<0.05。结论高强度聚焦超声辅助负压吸宫术与子宫动脉栓塞辅助负压吸宫术治疗剖宫产瘢痕部位妊娠的效果相当,但高强度聚焦超声辅助负压吸宫术在提高手术安全性、改善预后方面更具优势。Objective To compare the clinical efficacy of vacuum aspiration assisted by high-intensity focused ultrasound and uterine artery embolization in the treatment of cesarean scar pregnancy.Methods A total of 90 women with cesarean scar pregnancy admitted to Zhoukou Central Hospital from August 2019 to August 2022 were selected,and all of them were treated by vacuum aspiration.They were divided into group A(treated by uterine artery embolization)and group B(treated by high-intensity focused ultrasound)according to the adjuvant treatment plan,with 45 cases in each group.The clinical efficacy,safety and prognosis of the two groups were compared.Results After treatment,there was no significant difference in the total effective rate between the group A(95.56%,43/45)and the group B(97.78%,44/45),P>0.05.The incidence of fever,lower limb pain,nausea and vomiting in the group B were lower than those in the group A,while the incidence of lower abdominal and lumbosacral pain in the group B was higher than that in the group A(P<0.05).There was no significant difference in the rate of serum human chorionic gonadotropin conversion between the two groups 1 and 3 months after surgery(P>0.05).The 3-and 6-month postoperative rate of menstrual loss in the group B were lower than those in the group A(P<0.05).One year after surgery,the rate of repregnancy in the group B(42.22%,19/45)was higher than that in the group A(22.22%,10/45),P<0.05.Conclusions In the treatment of cesarean scar pregnancy,the effects of high-intensity focused ultrasound followed by vacuum aspiration and uterine artery embolization followed by vacuum aspiration are comparable.However,high-intensity focused ultrasound followed by vacuum aspiration has more advantages in improving surgical safety and prognosis.

关 键 词：剖宫产 瘢痕部位妊娠 高强度聚焦超声 负压吸宫术 子宫动脉栓塞 

分 类 号：R714.22[医药卫生—妇产科学]