海扶刀联合宫腔镜下负压清宫术治疗瘢痕妊娠的临床观察

Clinical observation of high intensity focused ultrasound combined with hysteroscopic negative pressure clearance for scar pregnancy

目的探讨高强度聚焦超声(海扶刀)联合宫腔镜下负压清宫术治疗瘢痕妊娠的临床效果。方法选取2021年7月至2023年3月惠州市第三人民医院妇科收治的100例剖宫产子宫瘢痕妊娠患者,按照随机数字表法分为对照组、试验A组、试验B组、试验C组,每组各25例。对照组采用传统清宫术治疗,试验A组采用宫腔镜下负压清宫术治疗,试验B组采用传统清宫术联合海扶刀治疗,试验C组采用宫腔镜下负压清宫术联合海扶刀治疗。比较各组治疗效果、妊娠物残留、病灶血流信号、阴道出血量、并发症发生情况。结果试验C组总有效率高于试验A组、试验B组及对照组(P<0.05)。试验C组妊娠物残留、病灶血流信号丰富占比低于试验A组、试验B组及对照组,阴道出血量少于其余三组(P<0.05)。试验C组并发症总发生率低于试验A组、试验B组及对照组(P<0.05)。结论海扶刀联合宫腔镜下负压清宫术治疗瘢痕妊娠的临床效果确切,可减少阴道出血量、妊娠物残留及并发症的发生,值得临床推广。

Objective To investigate the clinical effect of high intensity focused ultrasound(HIFU)combined with hysteroscopic negative pressure clearance for scar pregnancy.Methods A total of 100 cesarean section patients with uterine scar pregnancy admitted to the Department of Gynecology of the Third People’s Hospital of Huizhou from July 2021 to March 2023 were selected and divided into control group,trial group A,trial group B and trial group C according to the random number table method,with 25 cases in each group.The control group was treated with traditional uterine clearance,trial group A was treated with hysteroscopic negative pressure uterine clearance,trial group B was treated with traditional uterine clearance combined with HIFU,and trial group C was treated with hysteroscopic negative pressure uterine clearance combined with HIFU.The therapeutic effect,pregnancy residue,lesion blood flow signal,vaginal bleeding volume and complications were compared among all groups.Results The total effective rate of trial group C was higher than that of trial group A,trial group B and control group(P<0.05).The proportions of pregnancy residue and lesion blood flow signal abundance in trial group C were lower than those in trial group A,trial group B and control group,and the amount of vaginal bleeding in trial group C was lower than that in the other three groups(P<0.05).The total complication rate of trial group C was lower than that of trial group A,trial group B and control group(P<0.05).Conclusion The clinical effect of HIFU combined with hysteroscopic negative pressure clearance for scar pregnancy is exact,and it can reduce the amount of vaginal bleeding,pregnancy residue and complications,which is worthy of clinical promotion.