子宫动脉栓塞介入术治疗剖宫产子宫切口瘢痕处妊娠的效果

Effect of transcatheter uterine artery embolization on cesarean scar pregnancy

目的探讨子宫动脉栓塞介入术治疗剖宫产子宫切口瘢痕处妊娠的效果。方法选取驻马店市第一人民医院2017年3月至2018年3月剖宫产子宫瘢痕妊娠患者100例,根据随机数字表法分为两组,每组50例。对照组应用甲氨蝶呤肌肉注射联合清宫术治疗,观察组加用子宫动脉栓塞介入治疗。比较两组治疗情况、生殖激素水平及妊娠率。结果观察组术中出血量少,手术、住院时间均短于对照组,差异有统计学意义(P<0.05)。治疗后,两组促卵泡生成素、黄体生成素水平比较,差异未见统计学意义(P>0.05);观察组雌二醇、β人绒毛膜促性腺激素(β-hCG)水平低于对照组,差异有统计学意义(P<0.05);观察组阴道出血、β-hCG恢复、月经恢复时间均短于对照组,差异有统计学意义(P<0.05)。治疗后,观察组妊娠率[40.00%(20/50)]高于对照组[24.00%(12/50)],差异有统计学意义(χ^2=4.596,P=0.032)。结论子宫动脉栓塞介入术治疗剖宫产子宫切口瘢痕处妊娠的效果满意,可改善剖宫产子宫切口瘢痕处妊娠患者术后生殖激素水平,提高患者妊娠率。

Objective To investigate the effect of uterine artery embolization and interventional therapy on cesarean scar pregnancy.Methods From March 2017 to March 2018,100 pregnant women with uterine scar were selected from the First People's Hospital of Zhumadian.They were divided into two groups according to the random number table method,with 50 cases in each group.The control group was treated with methotrexate intramuscular injection combined with hysteroscopy,and the observation group was treated with uterine artery embolization.The treatment,reproductive hormone level and pregnancy rate were compared between the two groups.Results The amount of bleeding was less in the observation group,and the time of operation and hospitalization was shorter than those in the control group,the differences were significant(P<0.05).After treatment,there was no significant difference in the levels of FSH or LH between the two groups(P>0.05).The levels of E2 andβ-hCG in the observation group were lower than those in the control group,the difference were significant(P<0.05).The recovery time of vaginal bleeding,β-hCG and menstruation in the observation group were shorter than those in the control group,the differences were significant(P<0.05).After treatment,the pregnancy rate of the observation group was 40.00%(20/50),which was higher than that of the control group(24.00%,12/50),the difference was significant(χ^2=4.596,P=0.032).Conclusions The effect of transcatheter uterine artery embolization is satisfactory,which can improve the level of reproductive hormone and the pregnancy rate of patients with cesarean scar.