不同手术方式治疗子宫瘢痕妊娠临床效果分析

Clinical analysis of different surgical methods for the treatment of uterine scar pregnancy

目的探讨子宫动脉栓塞术+清宫术与经腹式子宫切口瘢痕妊娠清除术治疗子宫瘢痕妊娠患者的临床效果.方法将58例子宫瘢痕妊娠患者按手术方式不同分为宫动脉栓塞术+清宫术组(A组)29例和经腹式子宫切口瘢痕妊娠清除术组(B组)29例,比较两组手术指标(手术时间、术中出血量、住院时间)、术后恢复情况(血清绒毛促性腺激素恢复正常水平时间、月经恢复时间),以及术后并发症发生情况.结果A组手术时间显著短于B组(P<0.01),术后血清绒毛促性腺激素恢复正常水平及月经恢复时间均显著短于B组(P<0.01),术中出血量、住院时间及术后并发症发生率与B组比较差异均无统计学意义(P>0.05).结论子宫动脉栓塞术+清宫术与经腹式子宫切口瘢痕妊娠清除术治疗子宫瘢痕妊娠患者效果肯定;但子宫动脉栓塞术+清宫术在手术时间、血清绒毛促性腺激素恢复正常水平及月经恢复时间方面显著优于经腹式子宫切口瘢痕妊娠清除术.

Objective To investigate the clinical effect of uterine artery embolization(UAE)+uterine curettage and transabdominal uterine incision scar pregnancy removal in the treatment of uterine scar pregnancy.Methods 58 cases with cesarean scar pregnancy in our hospital were selected and randomly divided into group A,B,29 cases in each group,group A was given UAE+uterine curettage,group B was given transabdominal uterine incision scar pregnancy removal,compare the operation indexes(operation time,peroperative bleeding,hospital stay),postoperative recovery condition(β-HCG return to normal time,menstruation recovery time),postoperative complications between the two groups.Results The operation time,β-HCG return to normal time,menstruation recovery time in group A were all significantly shorter than those in group B(P<0.01);there was no statistic significance in the peroperative bleeding,hospital stay,postoperative complication rate between the two groups(P>0.05).Conclusion UAE+uterine curettage and transabdominal uterine incision scar pregnancy removal in the treatment of cesarean scar pregnancy have certain effect.However,UAE+uterine curettage was significantly superior to transabdominal uterine incision scar pregnancy removal in terms of operative time,normalβ-HCG return to normal time and menstrual recovery time.