子宫动脉栓塞术联合超声引导下清宫术治疗剖宫产瘢痕部位妊娠的效果及对术后卵巢功能的影响

Effect of uterine artery embolization combined with ultrasound-guided curettage in the treatment of cesarean scar pregnancy and its influence on postoperative ovarian function

目的分析子宫动脉栓塞术联合超声引导下清宫术治疗剖宫产瘢痕部位妊娠的效果及对术后卵巢功能的影响。方法选取我院2019年1月至2020年1月收治的66例剖宫产瘢痕部位妊娠孕妇为研究对象,采用随机数字表法将其分为参照组(n=33)和联合组(n=33)。参照组接受超声引导下清宫术治疗,联合组接受子宫动脉栓塞术联合超声引导下清宫术治疗。比较两组治疗前、治疗后6个月的卵巢储备功能指标、卵巢内分泌功能指标,治疗后14 d内并发症发生情况。结果治疗后6个月,两组的MOD、AMH水平、AFC均升高,且联合组高于参照组(P<0.05)。治疗后6个月,两组的LH、FSH水平均升高,且联合组高于参照组(P<0.05);两组的E2、P4水平均降低,且联合组低于参照组(P<0.05)。联合组治疗后14 d内并发症总发生率为3.03%,低于参照组的18.18%,差异具有统计学意义(P<0.05)。结论子宫动脉栓塞术联合超声引导下清宫术治疗剖宫产瘢痕部位妊娠的效果更好,有助于改善患者的卵巢储备功能、卵巢内分泌功能,减少术后并发症。

Objective To analyze the effect of uterine artery embolization combined with ultrasound-guided curettage in the treatment of cesarean scar pregnancy and its influence on postoperative ovarian function.Methods A total of 66 pregnant women with cesarean scar pregnancy admitted in our hospital from January 2019 to January 2020 were selected as the research objects and divided into reference group(n=33)and combined group(n=33)by random number table method.The reference group received ultrasound-guided curettage,and the combined group received uterine artery embolization combined with ultrasound-guided curettage.The indexes of ovarian reserve function and ovarian endocrine function before and 6 months after treatment,and the incidence of complications within 14 d after treatment were compared between the two groups.Results Six months after treatment,the MOD,AMH level and AFC in the two groups increased,and those in the combined group were higher than the reference group(P<0.05).Six months after treatment,the LH and FSH levels of the two groups increased,and those in the combined group were higher than the reference group(P<0.05),the E2 and P4 levels of the two groups decreased,and those in the combined group were lower than the reference group(P<0.05).The total incidence of complications within 14 d after treatment in the combined group was 3.03%,which was lower than 18.18%in the reference group,and the difference was staistically significant(P<0.05).Conclusion Uterine artery embolization combined with ultrasound-guided curettage in the treatment of cesarean scar pregnancy has a better effect,which is helpful to improve ovarian reserve function and ovarian endocrine function,and reduce complications.