超声监视下吸宫并病灶处球囊压迫治疗剖宫产瘢痕部位妊娠32例分析

Analysis of 32 cases of cesarean scar pregnancy treated by curettage under ultrasound monitoring and uterine cavity with balloon compression

目的探讨超声监视下吸宫并病灶处球囊压迫治疗剖宫产瘢痕部位妊娠(cesarean scar pregnancy,CSP)的有效性及安全性。方法选择2013年1月至2017年3月在泰山医学院附属聊城市第二人民医院接受治疗的CSP患者64例,采用随机数字表法将其分为对照组(32例)和研究组(32例)。对照组实施B超监视下吸宫术治疗,研究组在对照组治疗基础上增加folly氏尿管末端球囊形成水囊压迫病灶治疗,分析两组术中出血量、术后出血量、住院时间、血人绒毛膜促性腺激素(human chorionic gonadotropin,h CG)降至正常时间、并发症发生率。结果研究组的术中出血量、术后出血量、住院时间、血h CG降至正常时间、并发症发生率均低于对照组(P<0.05)。结论 B超监视下吸宫术加球囊压迫治疗早期CSP安全、有效,更符合微创原则,可作为早期CSP治疗的首选方案,值得临床推广应用。

Objective To explore the validity and safety of complete curettage under ultrasound monitoring and balloon compression in treating cesarean scar pregnancy （CSP）. Methods 64 patients with CSP treated in Second People ＇s Hospital of Liaocheng City from January 2013 to March 2017 were selected and randomly divided into control group （ n = 32 ） and study group （ n = 32）. The control group underwent ultrasound- assisted aspiration of the uterus. Based on the treatment of the control group, the study group was treated with balloon pressure treatment using folly ＇s end - capillaries to form the sac. The intraoperative blood loss, postoperative bleeding, hospital stay, the time of blood hCG down to normal, the incidence of complications of two groups were analyzed. Results Intraoperative blood loss, postoperative bleeding, hospital stay, the time of blood hCG down to normal, the incidence of complications of the study group were lower than those of the control group （ P 〈 0. 05 ）. Conclusion B - ultrasound assisted aspiration of uterus and balloon compression treatment of early CSP is safe and effective, more in line with the principle of minimally invasive, can be used as the first choice of treatment, and is worthy of clinical application.