高强度超声聚焦对剖宫产瘢痕部位妊娠的治疗效果

Therapeutic effect of high-intensity focused ultrasound in caesarean scar pregnancy

目的比较高强度超声聚焦配合清宫术与子宫动脉栓塞介入配合清宫术对于剖宫产瘢痕部位妊娠(cesarean scar pregnancies,CSP)的治疗效果。方法采用回顾性分析方法,纳入2014年1月至2019年1月在广州医科大学附属第三医院妇产科收治的CSP患者60例,分为观察组(高强度超声聚焦配合清宫术患者)30例与对照组(子宫动脉栓塞配合清宫术患者)30例,对比两组患者的治疗效果相关临床指标。采用t检验、χ^2检验对数据进行统计分析。结果观察组住院时间(6.87±2.64)d,低于对照组(10±4.79)d,Z=2.21,P<0.05;观察组住院费用(15524.47±8035.73)元,少于对照组(25390.80±12914.10)元,t=2.51,P<0.05;观察组月经恢复时间为(35.93±4.00)d,少于对照组(40.90±6.63)d,t=2.50,P<0.05;观察组术后疼痛发生率6.6%,低于对照组40%,χ^2=8.91,P<0.05。两组患者在术中阴道出血量、术后阴道出血持续时间、术后血HCG下降时间、胃肠道反应、术后发热及盆腔感染方面差异均无统计学意义(P>0.05)。结论高强度超声聚焦配合清宫术能降低CSP患者住院时间短,住院费用低,术后恢复月经时间更短,术后疼痛的发生率更低。

Objective To compare the therapeutic effect of high-intensity focused ultrasound with uterine curettage and uterine artery embolization with uterine curettage in cesarean scar pregnancies. Methods A retrospective analysis was conducted in 60 patients with cesarean section scars,who admitted to the Department of Obstetrics and Gynecology,the Third Affiliated Hospital of Guangzhou Medical University from January 2014 to January 2019.The patients were divided into observation group (high-intensity ultrasound with uterine curettage) and control group (uterine artery embolization with uterine curettage);30 cases in each group.T test or Chi -square tests were performed for test statistical analysis. Results The length of hospital stay in the observation group was (6.87±2.64) days,which was lower than that of the control group (10±4.79) days,Z=2.21,P <0.05.The hospitalization expenses of the observation group (15 524.47±8035.73) was less than that of the control group (25 390.80±12 914.10) yuan,t=2.51,P <0.05.The menstrual recovery time in the observation group was (35.93±4.00) days,less than that of the control group (40.90±6.63) days,t=2.50,P<0.05.The incidence rate of postoperative pain in the observation group was 6.6%,which was lower than 40% in the control group,χ^2=8.91,P <0.05.There were no significant differences in the amount of intraoperative vaginal bleeding,duration of postoperative vaginal bleeding,decline time of human chorionic gonadotropin in blood after operation,gastrointestinal reactions,postoperative fever and pelvic infection between the two groups ( P >0.05). Conclusion High-intensity focused ultrasound with uterine curettage shorten hospitalization time,lower hospitalization costs,decrease recovery time of menstruation after surgery and reduced the incidence of post-operative pain in the patients with cesarean scar pregnancy.