剖宫产切口瘢痕妊娠患者应用子宫动脉栓塞联合清宫术的治疗效果评价及对卵巢功能的影响

Evaluation of Therapeutic Effect of Uterine Artery Embolization Combined with Uterine Clearance in Pregnant Patients with Scar Incision During Cesarean Section and Its Influence on Ovarian Function

目的 探究分析剖宫产切口瘢痕妊娠患者应用子宫动脉栓塞联合清宫术的治疗效果及对卵巢功能的影响。方法 选取2019年1月—2023年2月东台市人民医院收治的83例剖宫产切口瘢痕妊娠患者作为研究对象,通过计算机分组法将其分成对照组(n=41)和研究组(n=42)。对照组采取清宫术,而研究组在此基础上联合子宫动脉栓塞术。比较两组患者的临床治疗指标、卵巢功能指标以及术后并发症发生情况。结果 研究组患者的术中出血量少于对照组、血人绒毛膜促性腺激素(β-human chorionic gonadotropin,β-HCG)转阴时间、住院时间、阴道流血消失时间短于对照组,差异有统计学意义(P<0.05)。术后,两组患者雌二醇(estradiol,E2)、促卵泡生成素(follicle-stimulating hormone,FSH)、促黄体生成素(luteinizing hormone,LH)水平与术前对比,差异无统计学意义(P>0.05);术前及术后两组的E2、FSH、LH指标水平对比,差异无统计学意义(P>0.05)。研究组术后并发症总发生率为2.38%,低于对照组的7.32%,但差异无统计学意义(χ^(2)=0.289,P>0.05)。结论 对于剖宫产切口瘢痕妊娠患者而言,应用子宫动脉栓塞联合清宫术的治疗效果显著,能减少术中出血量,术后恢复效果良好,可保留患者的卵巢功能,对其影响较小,并且术后并发症发生率较低,安全性良好。

Objective To explore and analyze the therapeutic effect of uterine artery embolization combined with uterine clearance in pregnant patients with scar incision during cesarean section and its influence on ovarian function.Methods A total of 83 patients with cesarean scar pregnancy admitted to Dongtai People's Hospital from January 2019 to February 2023 were selected as the research objects.They were divided into control group(n=41)and study group(n=42)by computer grouping method.The control group was treated with uterine curettage,while the study group was combined with uterine artery embolization on this basis.The clinical treatment indexes,ovarian function indexes and postoperative complications were compared between the two groups.Results The intraoperative blood loss in the study group was less than that in the control group,and the time ofβ-human chorionic gonadotropin(β-HCG)turning negative,hospitalization time and vaginal bleeding disappearance time were shorter than those in the control group,the differences were statistically significant(P<0.05).After opera⁃tion,there was no statistically significant difference in the levels of estradiol(E_(2)),follicle-stimulating hormone(FSH)and luteinizing hormone(LH)between the two groups compared to before operation(P>0.05);there was no statistically significant difference in the levels of E2,FSH and LH between the two groups before and after operation(P>0.05).The total incidence of postoperative complications in the study group was 2.38%,lower than 7.32%in the control group,but the difference was not statistically significant(χ^(2)=0.289,P>0.05).Conclusion For preg⁃nant patients with scar incision during cesarean section,uterine artery embolization combined with uterine clearance has significant therapeu⁃tic effect,which can reduce intraoperative blood loss,have good postoperative recovery effect,preserve the ovarian function of patients,have little impact on them,and have a low incidence of postoperative complications with good safety.