阴式瘢痕妊娠物清除术治疗高危型瘢痕妊娠效果

Effect of vaginal scar pregnancy removal for treating the high-risk scar pregnancy

目的:探究阴式瘢痕妊娠物清除术在高危型瘢痕妊娠(CSP)治疗效果。方法:选取高危型CSP患者以阴式瘢痕妊娠物清除术治疗53例为观察组,以倾向性评分匹配法按照1:1匹配以子宫栓塞术及超声引导下清宫术53例为对照组。比较两组手术情况,血绒毛膜促性腺激素(β-HCG)、血红蛋白(Hb)水平,生活质量测定量表(QOL-BREF)评估术后生活质量及术后并发症发生情况。结果:两组住院时间无差异(P>0.05),观察组βHCG恢复正常时间(15.2±1.5d)、术中出血量(15.4±1.6 ml)、月经恢复时间(32.6±3.4 d)均低于对照组(18.5±1.9d、23.5±2.4 ml、40.4±4.1 d)(P<0.05)。术前、术后10天两组Hb水平均无差异(P>0.05),术后10天两组血清β-HCG水平均降低且观察组低于对照组(P<0.05)。术后10天、30d环境、心理评分两组无差异(P>0.05),社会关系、生理评分对照组术后30d高于术后10d(P<0.05),观察组术后10d与术后30d无差异(P>0.05),但术后10d观察组高于对照组(P<0.05)。观察组有1例出现持续疼痛、1例出现术后血肿(3.8%),对照组有3例出现持续疼痛、1例出现发热(7.6%),两组并发症发生率无差异(P>0.05)。结论:阴式瘢痕妊娠物清除术治疗高危型CSP可有效促进患者术后恢复,减少术中出血量,提高生活质量。

Objective:To explore the effect of vaginal scar pregnancy removal for treating the high-risk scar pregnancy(SP).Methods:53 women with high-risk SP treated by vaginal scar pregnancy removal were selected in observation group,and 53 women were treated by uterine embolization and curettage under ultrasound guidance were matched in control group according to 1:1.The operation condition,and the levels ofβ-HCG and hemoglobin(Hb)of the women were compared between the two groups.The quality-of-life measurement scale(QOL-BREF)was used to evaluate the postoperative life quality and complications situation of the women in the two groups.Results:There were no significant differences in the hospital stay time of the women between the two groups(P>0.05).The recovery time ofβ-hCG level(15.2±1.5d),the intraoperative blood loss(15.4±1.6 ml),and the menstrual recovery time(32.6±3.4 d)of the women in the observation group were significantly lower than those(18.5±1.9d,23.5±2.4 ml,and 40.4±4.1 d)of the women in the control group(P<0.05).There was no significant difference in the Hb level of the women before operation and 10 days after operation between the two groups(P>0.05).The serumβ-HCG level of the women in the two groups in the 10th day after operation had decreased significantly,and which of the women in the observation group was significantly lower than that of the women in the control group(P<0.05).There were no significant differences in the environmental and psychological scores of the women in the 10th and 30th day after operation between the two groups(P>0.05).The scores of social relations and physiology of the women in the control group in the 30th day after operation were significantly higher than those in the 10th day after operation(P<0.05),but there were no significant differences in the scores of social relations and physiology of the women in the observation group between in the 10th after operation and in the 30th day after operation(P>0.05),and the scores of social relations and physiology of the women in the observation group in the 10th day after operation was significantly higher than that of the women in the control group(P<0.05).There were 1 woman with persistent pain and 1 woman with postoperative hematoma(3.8%)in the observation group,and there were 3 women with persistent pain and 1 woman with fever(7.6%)in the control group.There was no significant difference in the incidence of complications of the women between the two groups(P>0.05).Conclusion:Vaginal scar pregnancy removal for treating high-risk SP of the women can effectively promote their postoperative recovery,reduce their intraoperative blood loss,and improve their quality of life.