UAE联合清宫术和清宫术在剖宫产瘢痕妊娠治疗中的对比研究

Comparative study of uterine artery embolization combined with curettage and curettage in the treatment of cesarean scar pregnancy

目的探讨子宫动脉栓塞术(UAE)联合清宫术和清宫术治疗剖宫产瘢痕妊娠对患者内分泌激素、排卵和受孕的影响。方法选取94例剖宫产瘢痕妊娠患者,按治疗方案分为子宫动脉栓塞术联合清宫术组(观察组,47例)和清宫术组(对照组,47例),比较分析治疗效果,并随访3年内LH、FSH、E2的变化,监测排卵和受孕情况。结果观察组治疗成功率高于对照组,差异有统计学意义(P<0.05),术中出血量、术后阴道出血时间、血β-hCG转阴时间和月经恢复正常时间均减少,但住院时间增加,差异有统计学意义(P<0.05);3年内LH、FSH、E2的组内、组间比较差异无统计学意义(P>0.05);治疗后两组患者排卵率相当,但受孕率观察组51.72%高于对照组46.15%。结论子宫动脉栓塞术联合清宫术和清宫术治疗剖宫产瘢痕妊娠均安全可靠,但子宫动脉栓塞术联合清宫术的术后恢复具有优势。

Objective To investigate the effect of uterine artery embolization combined with curettage and curettage on endocrine hormone,ovulation and conception in patients with cesarean scar pregnancy.Methods According to the treatment plan,94 patients with cesarean scar pregnancy were divided into uterine artery embolization combined with uterine evacuation group(observation group,47 cases)and uterine evacuation group(control group,47 cases),the therapeutic effect was compared and analyzed,and the changes of LH,FSH,E2 and monitor the pregnancy were followed up for 3 years.Results The successful rate of treatment in the observation group was significantly higher than that in the control group(P<0.05).The amount of bleeding during operation,the time of vaginal bleeding after operation,the time ofβ-hcg turning negative in blood,the time of menses returning to normal were decreased,but the time of hospitalization was increased(P<0.05),There was no significant difference in LH,FSH,E2 within 3 years between groups(P>0.05),the ovulation rate of the two groups was the same,but the pregnancy rate of the observation group was 51.72%,higher than that of the control group 46.15%.Conclusion Both of uterine artery embolization combined with curettage and curettage are safe and reliable in the treatment of cesarean scar pregnancy,but uterine artery embolization combined with curettage has advantages in postoperative recovery.