两种手术方式用于Ⅰ、Ⅱ型剖宫产瘢痕妊娠患者的治疗效果  

Therapeutic efficacy of two surgical lmethods in patients with type Ⅰ and Ⅱ esarean scar pregnanc

作　　者：蒋伟菊 陈丹丹[1] 王文婷[1] 余韦 吴丹[2] JIANG Weiju;CHEN Dandan;WANG Wenting;YU Wei;WU Dan(Department of Family Planning,Women's Hospital of Nanjing Medical University,Nanjing Women and Children Healthcare Hospital,Nanjing 210004,CHINA)

机构地区：[1]南京医科大学附属妇产医院(南京市妇幼保健院)计划生育科,江苏210004 [2]南京医科大学附属妇产医院(南京市妇幼保健院)产科,江苏210004

出　　处：《江苏医药》2024年第9期877-881,共5页Jiangsu Medical Journal

基　　金：江苏省自然科学基金青年项目(BK20210038);南京市卫生科技发展专项资金项目(YKK22150)。

摘　　要：目的 比较两种手术方式用于Ⅰ、Ⅱ型剖宫产瘢痕妊娠(CSP)患者的治疗效果。方法 180例Ⅰ、Ⅱ型CSP患者分为两组,A组(83例)采取宫腔镜检查联合清宫术治疗,B组(97例)采用子宫动脉栓塞术(UAE)联合清宫术治疗。比较两组患者的临床资料、围手术期相关指标、术后并发症发生和术后转归。结果 与B组比较,A组手术时间长,总住院天数短,住院费用少,术后3d人绒毛膜促性腺激素(β-HCG)降低,β-HCG变化量升高,术后发热、栓塞后综合征、穿刺部位皮肤淤青、宫腔粘连和月经量减少发生率降低,β-HCG恢复正常时间、阴道流血时间和月经恢复时间短(P<0.05或P<0.01)。结论 与UAE联合清宫术比较,采用宫腔镜检查联合清宫术治疗Ⅰ、Ⅱ型CSP患者能明显降低β-HCG,减少术后并发症,缩短术后恢复时间。Objective To compare the therapeutic efficacy of two surgical methods in patients with type Ⅰ and Ⅱ Cesarean scar pregnancy(CSP).Methods A total of 180 type Ⅰ and Ⅱ CSP patients were divided into two groups.Group A(83 cases)was treated with hysteroscopy combined with curettage,and group B(97 cases)was treated with uterine artery embolization(UAE)combined with curettage.The clinical data,perioperative indexes,postoperative complications and outcomes of the two groups were compared.Results Compared with group B,the operation time was longer,total hospital stay was shorter,hospitalization cost was less,human chorionic gonadotropin(β-HCG)at 3 days after operation was decreased,the change ofβ-HCG was higher,the incidences of fever,postembolization syndrome,skin bruising at the puncture site,intrauterine adhesion and hypomenorrhea were reduced,and the recovery time ofβ-HCG,vaginal bleeding time and menstrual recovery time were shorter in group A(P<0.05 or P<0.01).Conclusion Compared with UAE combined with curettage,hysteroscopy combined with curettage in the treatment of type I and I CSP patients can significantly decreaseβ-HCG,reduce postoperative complications and shorten postoperative recovery time.

关 键 词：剖宫产瘢痕妊娠 宫腔镜 子宫动脉栓塞术 清宫术 

分 类 号：R714[医药卫生—妇产科学]