腹腔镜子宫动脉暂时阻断在剖宫产瘢痕妊娠诊治疗效探讨

Clinical study of laparoscopic uterine artery temporarily block in cesarean pregnancy

目的:研究子宫动脉暂时阻断在剖宫产瘢痕妊娠诊治疗效。方法:选取60例深圳市中西医结合医院2019年5月-2021年5月所收治的均经阴道超声考虑剖宫产瘢痕妊娠(cesarean scar pregnancy,CSP),采用随机数字表法将其分实验组与对照组各30例。其中腹腔镜下子宫动脉暂时阻断后行剖宫产瘢痕妊娠病灶去除术组为实验组,行子宫动脉栓塞后行腹腔镜下剖宫产瘢痕妊娠病灶去除术组为对照组,比较两组患者治疗成功率、手术时间、术中出血量、住院时间、不良反应,术后3个月子宫内膜厚度及子宫内膜血运。结果:实验组和对照组住院时间分别为(7.3±3.3)d、(8.9±4.2)d;住院费用为(13566.3±1967.2)元、(19250.6±1639.5)元;治疗不良反应发生率分别为:16.7%、56.7%;术后3个月子宫内膜厚度分别为(8.2±1.4)mm、(6.3±1.6)mm;以上比较差异均有统计学意义(P<0.05),两组患者治疗成功率分别为:97.6%;95.9%;手术时间分别为(94.7±15.2)min、(101.3±17.4)min;术中出血量分别为(125.3±35.2)mL、(123.6±67.3)mL,以上两项比较差异无统计学意义(P>0.05)。结论:相较于子宫动脉栓塞后行腹腔镜下剖宫产瘢痕妊娠病灶去除术,腹腔镜下子宫动脉暂时阻断后行剖宫产瘢痕妊娠病灶去除术在治疗剖宫产瘢痕妊娠成功率及安全性高,住院时间短,费用低,出血少及术后治疗不良反应比栓塞少,值得推荐。

Objective:To investigate the therapeutic effect of laparoscopic uterine artery temporarily block in cesarean pregnancy.Methods:A total of 60 cases of cesarean scar pregnancy(CSP)were selected from Shenzhen Hospital of Integrated Traditional and Western Medicine from May 2019 to May 2021.They were divided into the experimental group and the control group with 30 cases in each group according to the random number table.The experimental group was the one which was excision of cesarean scar pregnancy after laparoscopic uterine artery temporarily blocking,and the control group was the one which was excision of cesarean scar pregnancy after uterine artery embolism.The treatment success rate,operation time,intraoperative blood loss,hospital stay,adverse reactions,postoperative march endometrial thickness and endometrial blood supply were compared between the two groups.Results:The time in the in-department was(7.3±3.3)and(8.9±4.2)days in the experimental group and control group respectively.The hospitalization expenses were(13566.3±1967.2)and(19250.6±1639.5)yuan;The incidence of side reaction were 16.7%and 56.7%respectively.The endometrial thickness was(8.2±1.4)and(6.3±1.6)mm respectively after three months.The differences between the two groups were statisticaliy significant(P<0.05).The treatment success rate of the two groups were 97.6%and 95.9%respectively;The operation time was(94.7±15.2)min and(101.3±17.4)min respectively,the intraoperative blood loss was(125.3±35.2)mL and(123.6±67.3)mL respectively,The differences between the two groups were not statisticaliy significant(P>0.05).Conclusion:Compared with the control group(laparoscopic cesarean scar pregnancy lesion removal after uterine artery embolism),the experimental group(laparoscopic cesarean scar pregnancy lesion removal after uterine artery temporarily blocking)in the treatment of cesarean scar pregnancy has higher success rate and safety,shorter hospitalization time,lower cost,less bleeding and postoperative treatment side effects,which is worth recommending.