宫外孕Ⅱ号方联合子宫动脉栓塞术及清宫术治疗剖宫产瘢痕妊娠15例

Fifteen Cases of Cesarean Scar Pregnancy Treated with Formula Ⅱ Vterine Arter/Embolism and Complete Curettage of Uterine Cavity

目的:观察宫外孕Ⅱ号方联合子宫动脉栓塞术(uterine artery embolism,UAE)及清宫术治疗剖宫产瘢痕妊娠(cesarean scar pregnancy,CSP)的临床疗效。方法:将29例CSP患者随机分为对照组14例和治疗组15例。对照组行UAE加清宫术,治疗组在对照组的基础上入院后口服宫外孕Ⅱ号方加味。观察两组患者子宫动脉栓塞术后腹痛VAS评分、发热发生率、恶心呕吐等胃肠道反应率、清宫术所用时间、术中出血量及手术成功率。比较两组患者血β-HCG转阴所需时间、宫腔内包块消失所需时间、阴道出血持续时间及术后月经恢复所需时间。结果:治疗组腹痛VAS评分低于对照组,治疗组发热及胃肠道反应发生率均低于对照组,差异具有统计学意义(P <0. 05)。治疗组术中出血量低于对照组,差异有统计学意义(P <0. 05)。治疗组阴道出血时间、HCG转阴所需时间、包块吸收所需时间、月经复潮所需时间均短于对照组,差异有统计学意义(P <0. 05)。结论:宫外孕Ⅱ号方联合UAE及清宫术治疗剖宫产瘢痕妊娠,可明显减少术中出血量及术后并发症。

Objective:To observe the clinical curative effect of formula II for extrauterine pregnancy in combination with uterine artery embolism(UAE)and complete curettage of uterine cavity on cesarean scar pregnancy(CSP).Methods:A total of 29 patients with CSP were randomly divided into the control group with 14 cases and the treatment group with 15 cases.The control group was treated with UAE plus complete curettage of uterine cavity,while the treatment group was additionally treated with Supplemented formula II for extrauterine pregnancy for oral administration on the basis of the control group.The VAS score of abdominal pain,incidence of fever,gastrointestinal reaction rate of nausea and vomiting,time of uterine curettage,intraoperative bleeding volume and success rate of operation were observed.The time needed for blood beta-HCG to turn negative,the time needed for the disappearance of intrauterine mass,the duration of vaginal bleeding and the time needed for menstrual recovery after operation were compared between the two groups.Results:The VAS score of abdominal pain in the treatment group was lower than that in the control group,and the incidence of fever and gastrointestinal reaction in the treatment group was lower than that in the control group,with statistical significance(P<0.05).The amount of bleeding in the treatment group was lower than that in the control group(P<0.05).The time of vaginal bleeding,the time needed for HCG to turn negative,the time needed for mass absorption,and the time needed for menstruation in the treatment group were shorter than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:Formula II for extrauterine pregnancy in combination with UAE and complete curettage of uterine cavity has a remarkable efficacy on CSP,can obviously reduce the amount of bleeding during operation and the complications after operation.