对不同超声血流信号的子宫瘢痕妊娠患者进行子宫动脉栓塞术联合清宫术的效果对比

To compare the effects of uterine arterial embolization and hysterectomy in pregnancy with different ultrasound blood flow signals

目的 :对比对不同超声血流信号的子宫瘢痕妊娠患者进行子宫动脉栓塞术联合清宫术的临床效果。方法 :将2012年7月至2018年2月期间在昆山市第一人民医院和启东市人民医院进行子宫动脉栓塞术联合清宫术的120例子宫瘢痕妊娠患者作为研究对象。将这120例患者分为少量血流组(n=51)和血流丰富组(n=69)。对两组患者均进行子宫动脉栓塞术联合清宫术。然后,比较两组患者治疗的成功率、各项临床指标及其术中与术后相关并发症的发生率。结果 :两组患者治疗的成功率均为100%。与血流丰富组患者相比,少量血流组患者术中的出血量更少,其住院的时间、术后β-HCG(β-人绒毛膜促性腺激素)水平恢复正常的时间和术后阴道流血的时长均更短,P <0.05。两组患者术中与术后相关并发症的发生率相比,P>0.05。结论 :与超声血流信号较少的子宫瘢痕妊娠患者相比,超声血流信号丰富的子宫瘢痕妊娠患者在进行子宫动脉栓塞术联合清宫术时出血量更大,其术后恢复的速度更慢。因此,在对宫瘢痕妊娠患者进行子宫动脉栓塞术联合清宫术时,可将超声血流信号作为其手术风险和疗效的评价指标。

objective： to compare the clinical effects of uterine arterial embolization combined with hysterectomy in patients with uterine scar pregnancy with different ultrasound blood flow signals. Methods： 120 cases of pregnant women with uterine scar who underwent uterine arterial embolization combined with hysterectomy in kunshan first people＇s hospital and qidong people＇s hospital from July 2012 to February 2018 were studied. The 120 patients were divided into small blood flow groups（n=51） and rich blood flow groups（n=69）. Both groups were treated with uterine arterial embolization combined with hysterectomy. Then, the success rate, clinical indicators and the incidence of intraoperative and postoperative complications of the two groups were compared. Results： the success rate of the two groups was 100%. Compared with patients in the blood flow rich group, patients in the small blood flow group had less blood loss during the operation, and their hospitalization time, postoperative HCG（human chorionic gonadotropin） level returned to normal and postoperative vaginal bleeding time were shorter, P〈0.05. The incidence of intraoperative and postoperative complications in the two groups was compared, P〉0.05. Conclusion： compared with patients with uterine scar pregnancy who have less ultrasound blood flow signal, patients with uterine scar pregnancy who have abundant ultrasound blood flow signal have more blood loss and slower postoperative recovery rate when undergoing uterine artery embolization combined with hysterectomy. Therefore, the ultrasound blood flow signal can be used as the evaluation index of the surgical risk and curative effect of uterine arterial embolization combined with hysterectomy in patients with uterine scar pregnancy.