剖宫产术后子宫疤痕妊娠不同治疗方法的临床疗效分析

Clinical Analysis of Different Treatment Methods for Uterine Scar Pregnancy After Cesarean Section

目的分析不同治疗方法对剖宫产术后子宫疤痕妊娠的临床疗效。方法选取我院收治的剖宫产术后子宫疤痕妊娠患者20例作为研究对象。将其随机分为两组。A组(n=13)采用双侧子宫动脉介入术联合米非司酮片+米索前列醇药物治疗后清宫。B组(n=7)采用口服米非司酮片+米索前列醇药物治疗后行清宫术。比较两组清宫出血量,术后阴道出血时间,血清中β-HCG值以及降至正常时间。结果(1)A组术后3天血β-HCG下降幅度大于B组,差异具有统计学意义(P<0.05)。A组平均(17.4±2.1)d血β-HCG水平降至正常,与B组(25.8±3.3)d相比,差异具有统计学意义(P<0.05)。(2)A组清宫出血量为(38.4±8.5)ml,术后阴道出血时间为(4.4±2.1)d;B组清宫出血量为(127.3±14.3)ml,术后阴道出血时间(12.8±3.3)d。两组患者各指标比较,差异均具有统计学意义(P<0.05)。结论子宫动脉介入联合药物治疗后清宫能快速缩短β-HCG恢复时间,出血量更少,疗效显著且安全性高。

Objective To analyze the clinical curative effect of different treatment methods for uterine scar pregnancy after cesarean section. Methods 20 cases of patients with uterine scar pregnancy after cesarean section were selected as the research objects and were divided into two groups. Group A （n=13） received bilateral uterine artery intervention combined with mifepristone tablets and curettage after misoprostol drug treatment. Group B （n=7） was treated with oral mifepristone tablets and curettage after misoprostol drug treatment, and bleeding amount after curettage, time of vaginal bleeding after treatment, value of blood β-HCG and time of backing to normal were compared between the two groups. Results （1） the decrease of blood β-HCG in the group A was greater than that in the B group 3 days after operation, the difference was statistically significant （P 〈 0.05）. Group A average （17.4±2.1） d blood β-HCG level dropped to normal, compared with group B （25.8±3.3） d, the difference was statistically significant （P 〈 0.05）. （2） the amount of curettage in group A was （38.4±8.5） ml, the time of vaginal bleeding was （4.4±2.1） d. The amount of curettage in group B was （127.3±14.3） ml, the time of vaginal bleeding （12.8±3.3） d. The difference of the indexes between the two groups was statistically significant （P 〈 0.05）. Conclusion Curettage after uterine artery intervention combined with drug therapy can shorten recovery time of β-HCG, decrease bleeding volume, show certain curative effect and safety.