髂内动脉临时阻断术联合宫腔镜下病灶清除术在剖宫产瘢痕妊娠患者中的应用  

Application of Temporary Internal Iliac Artery Occlusion Combined with Lesion Resection in Patients with Caesarean Section Scar Pregnancy

作　　者：黄莉 范造锋 HUANG Li;FAN Zaofeng(Luoyang Maternal and Child Health Hospital,Luoyang 471099,China)

机构地区：[1]洛阳市妇幼保健院,河南洛阳471099

出　　处：《河南医学研究》2024年第19期3556-3559,共4页Henan Medical Research

摘　　要：目的探讨髂内动脉临时阻断术联合宫腔镜下病灶清除术在剖宫产瘢痕妊娠患者中的应用效果。方法采取前瞻性研究,将洛阳市妇幼保健院2020年10月至2022年10月收治的80例剖宫产瘢痕妊娠患者纳入研究,按随机数字表法分成两组,各40例。对照组接受子宫动脉栓塞术联合宫腔镜下病灶清除术治疗,观察组接受髂内动脉临时阻断术联合宫腔镜下病灶清除术治疗。观察记录两组患者的手术相关指标;于手术后12、24、48 h,通过视觉模拟评分法(VAS)评估患者疼痛程度;比较两组患者术后并发症总发生率。结果观察组患者手术时间、血人绒毛膜促性腺激素(β-HGG)恢复正常时间、住院时间均短于对照组,术中出血量少于对照组(P<0.05);两组术后12 h、24 h及48 h的VAS评分均持续降低,且观察组VAS评分低于对照组(P<0.05);观察组术后并发症总发生率低于对照组(P<0.05)。结论髂内动脉临时阻断术联合宫腔镜下病灶清除术能够减轻剖宫产瘢痕妊娠患者术后疼痛程度,降低术后并发症发生率,在剖宫产瘢痕妊娠患者的治疗中应用效果较好。Objective To investigate the effect of temporary internal iliac artery occlusion combined with hysteroscopic lesion clearance surgery in the treatment of caesarean section scar pregnancy.Methods Take a prospective study,eighty patients with scar pregnancy after caesarean section who were admitted to Luoyang Maternal and Child Health Care Hospital from October 2020 to October 2022 were included in the study.The patients were divided into two groups by random number table,with 40 cases in each group.The control group received uterine artery embolization combined with hysteroscopic lesion clearance surgery treatment,while the observation group received temporary internal iliac artery occlusion combined with hysteroscopic lesion clearance surgery treatment.The operation related indexes of the two groups were observed and recorded.The degree of pain was evaluated by visual analogue scale(VAS)at 12,24 and 48 hours after operation.The total incidence of postoperative complications was compared between the two groups.Results The surgery time,blood human chorionic gonadotropinβ(β-HGG)recovery time,and hospitalization time of the observation group patients were shorter than those of the control group,and the intraoperative bleeding volume was less than that of the control group(P<0.05).The VAS scores of the two groups of patients continued to decrease at 12,24,and 48 hours after surgery,and the VAS scores of the observation group were lower(P<0.05).The total incidence of postoperative complications in the observation group was lower(P<0.05).Conclusion Temporary internal iliac artery occlusion combined with hysteroscopic lesion clearance surgery can reduce the postoperative pain of caesarean section scar pregnancy patients,reduce the incidence of postoperative complications,and has a good effect in the treatment of caesarean section scar pregnancy patients.

关 键 词：剖宫产瘢痕妊娠 髂内动脉临时阻断术 宫腔镜 病灶清除术 子宫动脉栓塞术 

分 类 号：R713.4[医药卫生—妇产科学]