宫腔镜联合子宫动脉栓塞术对剖宫产术后瘢痕异位妊娠的治疗效果及安全性分析

doi:10.3969/j.issn.1006-6233.2018.08.027

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摘要 目的: 探讨宫腔镜及子宫动脉栓塞术联合治疗剖宫产切口瘢痕妊娠的效果及安全性。 方法: 收集2015年1月至2017年6月入院的剖宫产切口瘢痕妊娠患者70例,随机分为栓塞术组和联合组,各35例,栓塞术组患者给予传统治疗,联合组患者则予以宫腔镜联合子宫动脉栓塞术,比较两组患者围手术期指标、不良反应或并发症率、病灶直径、β-HCG水平与远期生活质量。 结果: 联合组患者术中出血量(32.08±9.12)、包块消失时间(5.36±0.78)、β-HCG转阴时间(4.77±0.60)、月经恢复时间(5.09±0.79)与住院时间(6.29±0.66)均显著性低于传统组(52.43±10.85,7.04±1.16,5.72±0.89,6.31±0.80,8.03±0.71);治疗后病灶直径(30.44±7.07)与β-HCG水平(4720±531)组间比较均显著性低于传统组(36.38±7.46,6035±712);治疗后6个月生理功能(71.25±8.04)、角色限制(83.12±8.78)、身体疼痛(75.60±8.31)、总体健康(72.90±7.67)与活力评分(85.12±8.40)组间比较均显著性高于传统组(62.47±7.95,74.56±7.83,67.13±8.22,64.78±7.96,76.45±8.70),存在显著性差异(P<0.01);两组患者总体不良反应或并发症率无显著差异(P>0.05)。 结论: 宫腔镜及子宫动脉栓塞术联合治疗剖宫产切口瘢痕妊娠的效果显著,安全性较高,具有借鉴意义。

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	李娜

关键词 ：宫腔镜, 子宫动脉栓塞术, 剖宫产, 瘢痕妊娠

Abstract：Objective: To investigate the efficacy and safety of hysteroscopic and uterine artery embolization in the treatment of cesarean scar pregnancy. Methods: 70 cases of cesarean scar pregnancy that were admitted from January 2015 to June 2017 were randomly divided into two groups. Patients in the embolization group were given traditional treatment. Hysteroscopy combined with uterine artery embolization was performed in the combined group. Comparing the perioperative indexes, adverse reactions or complication rate, lesion diameter, β-HCG level and long-term quality of life between the two groups. Results: Intraoperative blood loss (32.08±9.12), mass loss time (5.36±0.78), β-HCG negative time (4.77±0.60), menstrual recovery time (5.09±0.79) and length of stay (6.29±) 0.66) were significantly lower than the traditional group (52.43±10.85, 7.04±1.16, 5.72±0.89, 6.31±0.80, 8.03±0.71); the lesion diameter (30.44±7.07) and β-HCG levels (4720±531) after treatment Comparison between groups was significantly lower than the traditional group (36.38±7.46, 6035±712); 6 months after treatment, physiological function (71.25±8.04), role limitation (83.12±8.78), body pain (75.60±8.31), overall The difference between healthy (72.90±7.67) and vitality score (85.12±8.40) groups was significantly higher than that of the traditional group (62.47±7.95, 74.56±7.83, 67.13±8.22, 64.78±7.96, 76.45±8.70). There was a significant difference. (P<0.01); There was no significant difference in overall adverse reactions or complication rates between the two groups (P>0.05). Conclusion: Hysteroscopy and uterine artery embolization are effective and safe for cesarean scar pregnancy.

Key words： Hysteroscopy Uterine arterial embolization Cesarean section Scar pregnancy

基金资助:安徽省卫生科研项目,(编号:H201649216)

引用本文:

李娜. 宫腔镜联合子宫动脉栓塞术对剖宫产术后瘢痕异位妊娠的治疗效果及安全性分析[J]. 河北医学, 2018, 24(8): 1332-1335.
LI Na. Effect of Hysteroscopic Combined with Uterine Artery Embolization for the Treatment of Ectopic Pregnancy after Cesarean Section and its Safety Analysis. HeBei Med, 2018, 24(8): 1332-1335.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.08.027 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I8/1332