不同手术方式在子宫瘢痕妊娠患者治疗中的应用效果

Application effect of different surgical procedures in the treatment of cesarean scar pregnancy patients

目的研究不同手术方式在子宫瘢痕妊娠患者治疗中的效果及对其术后生活质量的影响。方法选择我院2014年6月~2017年5月收治的134例子宫瘢痕妊娠患者,按照随机数字表法分为A和B组,每组各67例。A组采取阴式子宫瘢痕妊娠清除及子宫修补术,B组采取双侧子宫动脉栓塞后清宫术,比较两组临床效果以及术后生活质量。结果两组术中出血量、人绒毛膜促性腺激素(β-HCG)恢复正常时间比较,差异无统计学意义(P>0.05);但A组手术时间较B组长(P<0.05)。A组总有效率为92.54%,与B组95.52%比较,差异无统计学意义(P>0.05)。两组术后3个月的心理、环境评分比较差异无统计学意义(P>0.05),但B组社会关系、生理评分高于A组(P<0.05);两组术后6个月的社会关系、生理、心理以及环境评分比较,差异无统计学意义(P>0.05)。结论两种手术方式在子宫瘢痕妊娠患者治疗中均具有一定应用效果,但双侧子宫动脉栓塞后清宫术效果更好,能够明显提高患者近期生活质量,促进病情快速稳定,为预后提供保障。

Objective To analyze the impact of different surgical procedures in the life quality for cesarean scar pregnancy patients.Methods A total of 134 cesarean scar pregnancy patients treated from June 2014 to May 2017 in our hospital were selected.The subjects were assigned to two groups according to random number table method,67 cases in each group.Group A was took the transvaginal resection plus uterus neoplasty;group B was took the bilateral uterine artery embolization plus complete curettage of uterine cavity.The clinical effect and life quality were probed.Results There were no significant between-group difference in the intraoperative blood loss and recovery time of human chorionic gonadotropin（β-HCG）（P〉0.05）;the operation time in the group A was significantly longer than that in the group B（P〈0.05）;there was no significant between-group difference in the total effective rate（92.54% vs.95.52%）（P〉0.05）;after 3 month of surgery,there were no significant between-group difference in the mental state and environment scores（P〉0.05）;the scores of social relations and physiological function in the group B were higher than that in the group A,with a statistical difference（P〉 0.05）;after 6 month of surgery,there were no significant between-group difference in the scores of social relations,physiological function,mental state and environment（P〉0.05）.Conclusion Both of the therapies have the fair effect in cesarean scar pregnancy.However,the bilateral uterine artery embolization plus complete curettage of uterine cavity can better improve the short-term life quality,stabilize the illness state and improve the clinical prognosis.