清宫术前预处理治疗剖宫产术后子宫瘢痕妊娠方法及效果观察

The method and effect of uterine scar pregnancy treated by curettage before curettage

目的探讨清宫术前预处理在剖宫产术后子宫瘢痕妊娠治疗方面及效果观察。方法选择2013年3月~2017年3月的54例清宫术的剖宫产术后子宫瘢痕妊娠患者,将其分为三组分别采用超声监测下清宫术;米非司酮后联合超声监测下清宫术;子宫动脉栓塞联合超声监测下清宫术。比较三种术前治疗方法的治疗效果。结果三组相比较临床指标,差异有统计学意义(P<0.05)。三组不良反应反应发生率分别为44.3%、20.8%、8.3%,差异有统计学意义(P<0.05)。三组治疗效果比较,差异有统计学意义(P<0.05)。结论子宫动脉栓塞联合超声监测下清宫术安全可靠,值得大力推广。

Objective To study the treatment and outcome of vacuum-curettage for caesarean scarred uterus.Methods A total of54cases of scaring uterus pregnancy followed caesarean section at a tertiary hospital from March2013to March2017were retrospectively researched.All the54cases received vacuum curettage for a purpose ofpregnancy termination during1trimester.Three groups were divided according to different pre-surgery management.Group A were given real-time ultrasound guided curettage.Group B received oral mifepristone prior to real-timeultrasound guided curettage.Group C had combined uterine artery embolization with ultrasound-guided curettage.Outcome was analyzed and compared.Results The three groups were compared with clinical indicators,withstatistical difference,(P<0.05).The incidence of adverse reactions in the three groups was44.3%,20.8%,8.3%,and(P<0.05).Compared with the three groups,the treatment effect was statistically significant,(P<0.05).ConclusionUterine artery embolization combined real-time ultrasound guided vacuum curettage is a safer and more reliablemanagement for cesarean scar pregnancies termination.It has a higher success rate and lower risk of adverse effects.The clinical outcome is more satisfactory and the management is more cost-effective.