海扶刀联合宫腔镜治疗瘢痕型妊娠的疗效及安全性

Efficacy and safety of HIFU combined with hysteroscopic surgery in the treatment of scar pregnancy

目的研究分析海扶刀联合宫腔镜对治疗瘢痕型妊娠的临床治疗疗效以及安全性。方法选取2017年1月至2019年1月河北省保定市妇幼保健院诊治的200例瘢痕型妊娠患者作为研究对象。根据患者手术方式进行分组,其中采用海扶刀联合宫腔镜手术治疗的97例患者作为观察组,采用宫腔镜联合清宫手术治疗的103例患者作为对照组,比较两组患者的临床治疗疗效、并发症情况以及比较两组患者手术情况以及术后恢复情况。结果观察组瘢痕型妊娠患者总有效率明显高于对照组,差异具有统计学意义(P<0.05)。观察组手术用时、术中出血量以及住院时间明显低于对照组,差异具有统计学意义(P<0.05);比较两组患者术后宫腔引流时间差异无统计学意义(P>0.05)。观察组患者血人绒毛膜促性腺激素恢复正常时间、月经恢复正常时间以及肛门排气时间明显短于对照组,观察组瘢痕型妊娠患者并发症发生率明显低于对照组瘢痕型妊娠患者,差异具有统计学意义(P<0.05)。观察组患者术后VAS评分明显低于对照组,差异具有统计学意义(P<0.05)。结论采用海扶刀联合宫腔镜手术治疗瘢痕型妊娠治疗疗效明显,能够减少瘢痕型妊娠手术时间、出血量,进而促进患者术后机体功能有效改善,且安全性较高。

Objective To study the clinical efficacy and safety of high-intensity focused ultrasound(HIFU)combined with hysteroscopic surgery in the treatment of scar pregnancy.Methods 200 patients with scar pregnancy in our hospital from January 2017 to January 2019 were selected and divided into observation group(n=97,HIFU combined with hysteroscopic surgery)and control group(n=103,hysteroscopy combined curettage)according to the surgical procedure.The clinical efficacy and complications as well as the operation condition and postoperative recovery of the two groups were compared.Results The total effective rate in observation group was significantly higher than that in control group(P<0.05).The operation time,intraoperative blood loss and hospitalization time of the observation group were significantly lower than those of the control group(P<0.05).There was no significant difference in the postoperative uterine cavity drainage time between the two groups(P>0.05).In the observation group,the recovery time of blood human chorionic gonadotropin(HCG)and menstruation as well as the anal exhaust time were significantly shorter than those of the control group(P<0.05).The incidence of complications in the observation group was significantly lower than that in the control group(P<0.05).The VAS scores of the observation group were significantly lower than those of the control group(P<0.05).Conclusions The treatment of scar pregnancy by HIFU combined with hysteroscopic surgery is effective,which can reduce the operation time and blood loss,and promote the effective improvement of postoperative body function with high safety.