负压吸引术治疗子宫瘢痕妊娠的疗效

Effect of negative pressure aspiration on uterine scar pregnancy

目的分析负压吸引术治疗子宫瘢痕妊娠（CSP）的疗效，评估CSP孕妇预后相关因素。方法选取CSP孕妇95例，采用B超监护下的负压吸引术对孕妇进行治疗。评估治疗的疗效，比较治疗成功孕妇与治疗失败孕妇的临床指标，包括：年龄、流产次数、膀胱壁与孕囊间子宫肌层厚度、孕次、本次妊娠与上次剖宫产间隔、顶臀径（CRL）等。采用logistics相关性分析评估CSP预后的相关因素。结果95例CSP孕妇中，治疗成功86例（90.5%），治疗失败9例（9.5%）。与治疗失败病例比较，治疗成功病例CRL水平显著提高，差异有统计学意义（P＝0.046）。Logistic回归分析表明，CRL与CSP孕妇的预后相关，以CRL＝6 mm作为界值，Logistics回归分析表明，CRL〉6 mm患者与CRL≤6 mm患者间成功率的OR值为18.51。结论对于CRL≤6 mm的CSP孕妇，B超监护下的负压吸引术可以作为首选的治疗方法。

Objective To analyze the efficacy of negative pressure aspiration on uterine scar pregnancy （CSP）, and assess the prognostic factors in pregnant women with CSP. Methods Ninty-five pregnant women with CSP were treated by negative pressure aspiration under B ultrasonic monitoring. The effects were evaluated. The age, number of abortion, myometrial thickness between bladder wall and ges- tational sac, gravidity, intervals of pregnancy to the last cesarean delivery, cruwn-rump length （CRL） were compared between pregnant women with successful treatment and treatment failure. The related prognostic factors of CSP were assessed by Logistic regression analysis. Results Among the 95 cases of CSP, the treatment was successful in 86 cases （90. 5% ） and failed in 9 cases. Compared with the pa- tients with treatment failure, the level of CRL in patients with treatment success was significantly higher （P = 0. 046）. Logistics regression analysis showed that CRL was correlated with the prognosis of CSP. With CRL = 6mm as the criteria, Logistics regression analysis showed the OR was 18.51 that the success- ful rate between CRL 〉6 mm and the CRL≤6 ram. Conclusions Negative pressure aspiration under B ultrasonic is the preferred treatment for uterine scar pregnancy whom CRL≤6 ram.