子宫动脉栓塞术和经阴道子宫瘢痕妊娠切除术治疗剖宫产瘢痕妊娠的疗效比较

Comparison of Uterine Arterial Embolization and Transvaginal Excision for Cesarean Scar Pregnancy

目的对比经阴道前穹窿子宫瘢痕妊娠切除术与子宫动脉栓塞术治疗剖宫产瘢痕妊娠(CSP)的差异。方法选取CSP患者70例作为研究对象。其中59例进行了子宫动脉栓塞术+清宫术治疗(A组),11例行经阴道子宫瘢痕妊娠切除术(B组)。比较2组患者术中出血量、手术时间、术中并发症(大量出血、子宫破裂)、住院时间以及住院费用。结果 2组住院时间、出血量比较差异无统计学意义(P>0.05);A组治疗费用高于B组[(15 442.2±4 220.0)元比(7 827.3±1 695.2)元,P<0.05]、而手术时间少于B组[(21.6±32.60)min比(55.4±13.3)min,P<0.05]。A组中2例患者在子宫动脉栓塞后的清宫术中出现大出血,急诊改行腹式瘢痕妊娠切除术。结论经阴道子宫瘢痕妊娠切除术具有安全性高、住院费用低、恢复快等优点,在CSP的临床治疗上更具有普及价值。

Objective To compare the effects of uterine arterial embolization and transvaginal excision on cesarean scar pregnancy（CSP）.Methods Seventy CSP patients were assigned to re-ceive either uterine arterial embolization＋ curettage（group A）or transvaginal excision of CSP （group B）.Intraoperative blood loss,operation time,complications（massive hemorrhage and uter-ine rupture）,hospital stay,and hospitalization costs were compared between the two groups.Re-sults There were no significant differences in hospital stay and blood loss between the two groups（P 〉0.05）.Compared with group B,hospitalization costs increased and operation time de-creased in group A（（15 442.2±4 220.0）yuan vs（7 827.3±1 695.2）yuan and（21.6±32.60）mi-nutes vs（55.4±13.3）minutes,respectively;P 〈0.05）.In addition,2 patients in group A were converted to transabdominal excision of CSP due to massive haemorrhage during curettage.Con-clusion Transvaginal excision of CSP is associated with high safety,low hospitalization costs and fast recovery.Therefore,it is worthy of popularization in the treatment of CSP.