经阴道局部病灶清除术联合子宫壁修补术治疗瘢痕妊娠的效果及对患者miR-323-3p、β-HCG水平的影响

Effect of transvaginal local lesion removal combined with uterine wall repair in the treatment of scar pregnancy and its influence on the levels of miR-323-3p andβ-HCG in patients

目的探讨经阴道局部病灶清除术联合子宫壁修补术治疗瘢痕妊娠的效果及对患者miR-323-3p、β-人绒毛膜促性腺激素(β-HCG)水平的影响。方法选取2017年1月至2021年1月我院收治的68例瘢痕妊娠患者,以随机数字表法将其分为对照组(34例,甲氨蝶呤联合清宫术)和观察组(34例,经阴道局部病灶清除术联合子宫壁修补术)。比较两组的手术效果。结果观察组的手术时间长于对照组,术中出血量少于对照组,术后住院时间、病灶缩小时间、月经复潮时间均短于对照组,差异具有统计学意义(P<0.05)。观察组的并发症总发生率为5.88%,明显低于对照组的23.53%,差异具有统计学意义(P<0.05)。术后1 d,观察组的miR-323-3p、β-HCG水平均低于对照组,差异具有统计学意义(P<0.05)。术后1 d,观察组的VEGF、P水平均低于对照组,差异具有统计学意义(P<0.05)。结论经阴道局部病灶清除术联合子宫壁修补术治疗瘢痕妊娠的效果显著,有助于减少术中出血,促进患者术后快速恢复,减少并发症,并下调miR-323-3p、β-HCG水平,值得推广。

Objective To explore the effect of transvaginal local lesion removal combined with uterine wall repair in the treatment of scar pregnancy and its influence on the levels of miR-323-3p andβ-human chorionic gonadotropin(β-HCG)in patients.Methods A total of 68 patients with scar pregnancy treated in our hospital from January 2017 to January 2021 were selected and divided into control group(34 cases,methotrexate combined with uterine evacuation)and observation group(34 cases,transvaginal local lesion removal combined with uterine wall repair)by random number table method.The surgical effects of the two groups were compared.Results The operation time in the observation group was longer than that in the control group,the amount of intraoperative bleeding was less than that in the control group,the postoperative hospital stay,lesion reduction time and menstrual rehydration time were shorter than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was 5.88%,which was significantly lower than 23.53%in the control group,and the difference was statistically significant(P<0.05).One day after operation,the miR-323-3p andβ-HCG levels in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).One day after operation,the VEGF and P levels in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Transvaginal local lesion removal combined with uterine wall repair in the treatment of scar pregnancy has a significant effect,it can helps to reduce intraoperative bleeding,promote postoperative rapid recovery of patients,reduce complications,and down regulate miR-323-3p andβ-HCG levels,which is worthy of promotion.