子宫动脉栓塞术后清宫术治疗剖宫产术后子宫瘢痕妊娠的临床效果研究  

Study on clinical effect of uterine artery embolization followed by curettage in the treatment of uterine scar pregnancy after caesarean section

作　　者：周刚 ZHOU Gang(People's Hospital of Liuzhi Special District,Liupanshui 553400,China)

机构地区：[1]贵州省六盘水市六枝特区人民医院,553400

出　　处：《中国实用医药》2024年第18期64-66,共3页China Practical Medicine

摘　　要：目的探讨对剖宫产术后子宫瘢痕妊娠患者使用子宫动脉栓塞术后清宫术治疗的临床效果。方法72例剖宫产术后子宫瘢痕妊娠患者作为研究对象,随机分为对照组(36例)及观察组(36例)。对照组给予开腹病灶清除术或药物联合宫腔镜下清宫术治疗,观察组使用子宫动脉栓塞术后清宫术治疗。比较两组患者手术情况及临床指标,术后不良反应发生情况。结果观察组术中出血量(50.25±13.05)ml少于对照组的(85.35±14.00)ml,手术时间(1.02±0.54)h、住院时间(4.95±2.05)d、人绒毛膜促性腺激素(β-HCG)降至正常时间(16.85±3.80)d短于对照组的(1.65±0.68)h、(7.50±2.15)d、(27.05±5.85)d,比较有统计学意义(P<0.05)。观察组患者术后出现月经不调2例、下腹痛1例,不良反应发生率为8.3%(3/36);对照组患者术后出现月经不调5例、大出血3例、下腹痛2例、低热1例,不良反应发生率为30.6%(11/36)。观察组患者术后不良反应发生率明显低于对照组,比较有统计学意义(χ^(2)=5.675,P=0.017<0.05)。结论临床中剖宫产术后子宫瘢痕妊娠患者使用子宫动脉栓塞术后清宫术治疗,能缩短患者的手术时间、住院时间,减少术中出血量,使患者的不适感减轻,且术后血清中β-HCG恢复正常水平较快,该治疗方式值得临床进一步推广应用。Objective To explore the clinical effect of uterine artery embolization followed by curettage in the treatment of uterine scar pregnancy after caesarean section.Methods 72 patients with uterine scar pregnancy after caesarean section were selected as study subjects and randomly divided into a control group(36 cases)and an observation group(36 cases).The control group was treated with open focus removal or drug combined with hysteroscopic curettage,and the observation group was treated with uterine artery embolization followed by curettage.The operation status,clinical indicators and postoperative adverse reactions were compared between the two groups.Results The intraoperative blood loss of(50.25±13.05)ml in the observation group was less than(85.35±14.00)ml in the control group;in the observation group,the operation time was(1.02±0.54)h,the hospital stay was(4.95±2.05)d,and the time forβ-human chorionic gonadotropin(β-HCG)reduced to the normal level was(16.85±3.80)d,which were shorter than(1.65±0.68)h,(7.50±2.15)d,and(27.05±5.85)d in the control group;there was a statistical significance(P<0.05).In the observation group,2 cases of irregular menstruation and 1 case of lower abdominal pain occurred after surgery,and the incidence of adverse reactions was 8.3%(3/36);in the control group,5 cases of irregular menstruation,3 cases of massive hemorrhage,2 cases of lower abdominal pain and 1 case of low fever occurred after surgery,and the incidence of adverse reactions was 30.6%(11/36).The incidence of postoperative adverse reactions in the observation group was significantly lower than that in the control group,and there was a statistical significance(χ^(2)=5.675,P=0.017<0.05).Conclusion In the clinical treatment of pregnant women with uterine scar pregnancy after caesarean section,uterine artery embolization followed by curettage can shorten the operation time,hospital stay,reduce the amount of bleeding,alleviate the discomfort of patients,andβ-HCG recovers to normal levels quickly,and this method is worth

关 键 词：子宫动脉栓塞术 清宫术 剖宫产 子宫瘢痕妊娠 

分 类 号：R714.22[医药卫生—妇产科学]