垂体后叶素联合B超导向下清宫术在Ⅰ型剖宫产瘢痕妊娠患者中的应用效果

Application of pituitrin combined with B-ultrasound guided curettage in patients with typeⅠcesarean section scar pregnancy

目的探讨Ⅰ型剖宫产瘢痕妊娠患者使用垂体后叶素联合B超导向下清宫术治疗的临床疗效。方法回顾性分析2018年1月至2019年11月在我院妇科就诊的Ⅰ型剖宫产瘢痕妊娠患者78例,按治疗方法不同分为两组,观察组48例,予宫颈注射垂体后叶素联合B超导向下清宫术,对照组30例,予双侧子宫动脉栓塞术联合B超导向下清宫术,观察两组患者临床结局和不良反应等相关指标。结果观察组在首次清宫术后住院时间、平均总住院时间、平均总住院费用、术后不良反应均低于对照组,差异有统计学意义(P<0.05);而两组在手术成功率、首次清宫手术时间、首次清宫术中出血量、首次清宫术后Hb下降情况、术后β-HCG恢复正常时间、首次月经复潮时间、术后阴道出血时间等方面比较,差异无统计学意义(P>0.05)。结论对于Ⅰ型剖宫产瘢痕妊娠患者,垂体后叶素联合B超导向下清宫术安全、有效,并且操作简便,费用低,值得基层医院临床推广。

Objective To investigate the clinical efficacy of pituitrin combined with B-ultrasound guided curettage in patients with typeⅠcesarean section scar pregnancy.Methods The clinical data of 78 patients with typeⅠcesarean section scar pregnancy who visited the gynecology department of our hospital from January 2018 to November 2019 was retrospectively analyzed.They were divided into two groups according to different treatment methods,48 cases in the observation group treated with cervical injection of pituitrin combined with B-ultrasound guided curettage and 30 cases in the control group treated with bilateral uterine artery embolization combined with B-ultrasound guided curettage.The clinical outcomes,adverse reactions and other related indicators of the two groups were observed.Results The observation group's hospitalization time after the first curettage,average total hospitalization time,average total hospitalization cost,and postoperative adverse reactions were lower than those of the control group,and the differences were statistically significant(P<0.05).However,there were no statistically significant differences between the two groups in terms of surgical success rate,time,and blood loss of the first curettage,postoperative hemoglobin(Hb)drop,time of recovery ofβ-human chorionic gonadotrophin(β-HCG)after operation,time of first menstrual re-fluid,time of postoperative vaginal bleeding,etc.(P>0.05).Conclusion For patients with typeⅠcesarean section scar pregnancy,pituitrin combined with B-ultrasound guided curettage is safe,effective,easy to operate,with low cost,and worthy of clinic al promotion in grass-roots hospitals.