不同直径明胶海绵在子宫瘢痕妊娠患者子宫动脉栓塞术中的应用效果

Application of gelatin sponges with different diameters in uterine artery embolization in patients with uterine scar pregnancy

目的探究不同直径明胶海绵在子宫瘢痕妊娠患者子宫动脉栓塞术(UAE)中的应用效果。方法回顾性分析2016年5月至2020年6月于本院行UAE治疗的150例子宫瘢痕妊娠患者的临床资料,将术中采用直径350~560μm明胶海绵颗粒的48例患者作为A组,将术中采用直径>560~710μm明胶海绵颗粒的50例患者作为B组,将术中采用直径710~1000μm明胶海绵颗粒的52例患者作为C组。比较3组治疗前后性激素水平、清宫术出血量、人绒毛膜促性腺激素(hCG)恢复时间、术后腹部疼痛程度及并发症发生率。结果术前及术后1个月,3组雌二醇(E2)、黄体生成素(LH)、卵泡刺激素(FSH)水平比较差异无统计学意义,且3组术后1个月与术前比较差异无统计学意义。3组清宫术出血量、hCG恢复时间比较差异无统计学意义。术后1 d,C组腹部疼痛程度低于A组、B组,差异有统计学意义(P<0.05)。C组并发症发生率低于A组、B组,差异有统计学意义(P<0.05)。结论采用不同直径明胶海绵进行UAE治疗均可有效终止瘢痕妊娠,不会影响机体雌激素水平,但采用直径较大的明胶海绵可缓解术后腹部疼痛程度,且术后并发症发生率较低。

Objective To explore the application effect of gelatin sponge with different diameters in uterine artery embolization(UAE)for pa-tients with uterine scar pregnancy.Methods The clinical data of 150 cases of uterine scar pregnancy treated by UAE in our hospital from May 2016 to June 2020 were retrospectively analyzed,48 patients with 350-560μm gelatin sponge particles were used as group A,50 patients with 560-710μm gelatin sponge particles were used as group B,and 52 patients with 710-1000μm gelatin sponge particles were used as group C.Before and after treatment,the levels of sex hormones,the amount of bleeding after curettage,the recovery time of human chorionic gonadotropin(hCG),the degree of postoperative abdominal pain and the incidence of complications were compared among the three groups.Results Before and 1 month after oper-ation,there was no significant difference in the levels of estradiol(E2),luteinizing hormone(LH)and follicle stimulating hormone(FSH)among the three groups.1month after operation,there was no significant difference compared with before operation among the three groups.There was no sig-nificant difference in blood loss and recovery time of hCG among the three groups.On the 1st day after operation,the degree of abdominal pain in group C was lower than that in groups A and B,and the difference was statistically significant(P<0.05).The incidence of complications in group C was lower than that in groupAand B,and the difference was statistically significant(P<0.05).Conclusion Using gelatin sponge with different diam-eters to treat UAE can effectively terminate scar pregnancy without affecting estrogen level,but using gelatin sponge with larger diameter can relieve postoperative abdominal pain,and the incidence of postoperative complications is lower.