高强度超声聚焦消融术联合宫腔镜治疗子宫瘢痕妊娠的效果分析

Effect of High-intensity Ultrasound Focused Ablation Combined with Hysteroscopy in the Treatment of Cesarean Scar Pregnancy

目的:分析高强度超声聚焦消融术联合宫腔镜治疗子宫瘢痕妊娠的效果。方法:收集笔者所在医院2018年4月-2019年12月接收的384例子宫瘢痕妊娠患者进行研究,按住院号的奇偶数将其分为研究组(198例)与对照组(186例)。对照组采用宫腔镜手术治疗,研究组采用高强度超声聚焦消融术联合宫腔镜手术治疗。比较两组临床指标、手术成功率、治愈率、不良反应及并发症发生率。结果:研究组术中出血量少于对照组,阴道流血时间短于对照组,差异均有统计学意义(P<0.05)。研究组血β-hCG下降幅度大于对照组,差异有统计学意义(P<0.05)。两组住院时间比较差异无统计学意义(P>0.05)。研究组手术成功率为93.94%,治愈率为97.98%,均高于对照组的91.40%、87.10%,差异有统计学意义(P<0.05)。研究组并发症发生率为2.53%,低于对照组的15.05%,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:高强度超声聚焦消融术联合宫腔镜治疗子宫瘢痕妊娠的效果良好,术中出血少,术后恢复快,可促进血β-hCG指标恢复正常,治愈率高。

Objective:To analyze the effect of high-intensity ultrasound focused ablation combined with hysteroscopy in the treatment of cesarean scar pregnancy.Method:A total of 384 patients with cesarean scar pregnancy admitted in our hospital from April 2018 to December 2019 were collected for study,and were divided into the study group (198 cases) and the control group (186 cases) according to the odd even number of hospitalization number.The control group was treated with hysteroscopy surgery,and the study group was treated with high-intensity ultrasound focused ablation combined with hysteroscopy surgery.The clinical indexes,surgical success rate,cure rate,adverse reactions and complication rate were compared between the two groups.Result:The amount of intraoperative bleeding in the study group was less than that in the control group,and the vaginal bleeding time were shorter than those in the control group,the difference was statistically significant (P<0.05).The decrease of β-hCG in the study group was higher than that in the control group,and the difference was statistically significant (P<0.05).There was no significant difference in the hospitalization time between the two groups (P>0.05).The surgical success rate and cure rate of the study group were 93.94% and 97.98% respectively,both of which were higher than 91.40% and 87.10% of the control group,the differences were statistically significant (P<0.05).The complication rate of the study group was 2.53%,which was lower than 15.05% of the control group,the difference was statistically significant (P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05).Conclusion:High-intensity ultrasound focused ablation combined with hysteroscopy has a good effect in the treatment of cesarean scar pregnancy,with less intraoperative bleeding and faster postoperative recovery,which can promote the restoration of blood β-hCG indexes to normal,and a high cure rate.