子宫动脉栓塞联合超声引导清宫治疗剖宫产后瘢痕妊娠的疗效分析

Curative effect analysis of uterine artery embolization combined with ultrasound-guided curettage in cesarean scar pregnancy

目的探讨超声引导清宫与子宫动脉栓塞联合治疗剖宫产后瘢痕妊娠(cesarean scar pregnancy,CSP)患者的临床效果。方法选取溧阳市人民医院和常州市第一人民医院2007年1月至2015年8月剖宫产后瘢痕妊娠患者40例,根据随机数字表法分为研究组、对照组,每组20例。研究组进行超声引导清宫与子宫动脉栓塞联合治疗,对照组进行甲氨蝶呤孕囊内注射疗法,随访3个月,比较两组的临床效果、肿块消失时间、阴道流血持续时间、血β-HCG指标。结果研究组痊愈率高于对照组,肿块消失时间、阴道流血持续时间、血β-HCG水平显著优于对照组,差异有统计学意义(P<0.05)。结论剖宫产瘢痕妊娠患者进行超声引导清宫与子宫动脉栓塞联合疗法,附件肿块消除迅速,可显著改善患者的临床指标,痊愈率高,值得临床推广。

Objective To explore the clinical effect of ultrasound- guided curettage combined with uterine artery embolization in patients with cesarean scar pregnancy（ CSP）. Methods 40 CSP patients treated from January of 2007 to August of 2015 in Liyang People＇s Hospital and the First People＇s Hospital of Changzhou were selected. The patients were randomly divided into study group and control group,20 cases in each group. The study group adopted ultrasound- guided curettage combined with uterine artery embolization,while the control group adopted the combined therapy of methotrexate. After 3 months of follow- up visits,the clinical effects,disappearing time of lumps,duration of vaginal bleeding and β- HCG levels of two groups were compared. Results The cure rate of study group was significantly higher than that of control group,and the disappearing time of lumps,duration of vaginal bleeding and β- HCG level of study group were better than that of control group（ P〈0. 05）. Conclusion The ultrasound- guided curettage combined with uterine artery embolization has a higher effective rate and obvious clinical effect in CSP patients,can eliminate the lumps quickly and greatly improve the clinical index. It is worthy of clinical promotion.