子宫动脉栓塞术联合清宫术治疗剖宫产瘢痕妊娠患者的效果

Effects of uterine artery embolization combined with uterine curettage in treatment of cesarean scar pregnancy patients

目的:观察子宫动脉栓塞术(UAE)联合清宫术治疗剖宫产瘢痕妊娠患者的效果。方法:选取2019年3月至2020年12月该院收治的78例剖宫产瘢痕妊娠患者进行前瞻性研究,按照随机数字表法分为对照组和观察组各39例。对照组采用氨甲蝶呤联合清宫术治疗,观察组采用UAE联合清宫术治疗,比较两组手术相关指标水平、住院时间、预后情况及并发症发生率。结果:观察组清宫术出血量少于对照组,清宫术时间和住院时间均短于对照组,差异有统计学意义(P<0.05);观察组术后阴道流血时间、β-人绒毛膜促性腺激素(β-HCG)转阴时间、月经恢复时间、子宫病灶消失时间均短于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:UAE联合清宫术治疗剖宫产瘢痕妊娠患者,可改善手术相关指标水平和预后情况,其效果优于氨甲蝶呤注射液联合清宫术治疗。

Objective:To observe effects of uterine artery embolization(UAE)combined with uterine curettage in treatment of cesarean scar pregnancy patients.Methods:78 patients with scar pregnancy who were treated in this hospital from March 2019 to December 2020 were selected for the prospective study,and were divided into control group and observation group according to the random number table method,39 cases in each group.The control group was treated with Methotrexate combined with uterine curettage,while the observation group was treated with UAE combined with uterine curettage.The levels of surgery-related indicators,the hospitalization time,the prognosis,and the incidence of complications were compared between the two groups.Results:The bleeding volume of uterine curettage in the observation group was less than that in the control group;the time of uterine curettage and the hospitalization time were shorter than those in the control group;and the differences were statistically significant(P<0.05).The postoperative vaginal bleeding time,theβ-human chorionic gonadotropin(β-HCG)negative conversion time,the menstrual recovery time,and the uterine lesion disappearance time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:UAE combined with uterine curettage in the treatment of the patients with cesarean scar pregnancy can improve the levels of surgery-related indicators and the prognosis.Moreover,it is superior to MTX injection combined with uterine curettage.