摘要
目的评估病灶切除联合子宫动脉结扎术治疗瘢痕妊娠的临床疗效。方法选取西安工会医院2017年2月至2018年2月期间收治的112例瘢痕妊娠患者作为研究对象,按照随机数表法将其分为观察组和对照组各56例。对照组采用宫腔镜病灶切除术治疗,观察组采用宫腔镜病灶切除术联合腹腔镜子宫动脉结扎术治疗。比较两组患者的临床疗效、手术时间、术中出血量、住院时间、治疗费用、术后并发症、人绒毛膜促性腺激素(血HCG)恢复正常时间、月经恢复时间,以及术后随访两年内再次妊娠、不良妊娠结局和再次瘢痕妊娠等发生情况。结果观察组患者的治疗总有效率为94.6%,明显高于对照组的80.4%,差异有统计学意义(P<0.05);观察组患者的手术时间、术中出血量、住院时间及治疗费用分别为(60.0±5.8)min、(162.5±6.5)mL、(11.2±1.9)d、(1.5±0.6)万元,明显长于或多于对照组的(50.8±6.0)min、(49.8±6.2)mL、(6.8±1.5)d、(0.9±0.4)万元,血HCG恢复正常时间、月经恢复时间分别为(24.8±3.3)d、(31.9±3.2)d,明显短于对照组的(32.9±3.9)d、(41.8±4.2)d,差异均有统计学意义(P<0.05);随访2年内,观察组患者再次妊娠、不良妊娠结局及再次瘢痕妊娠率分别为3.57%、1.78%、1.78%,对照组分别为1.78%、1.78%、3.57%,差异均无统计学意义(P>0.05);观察组患者术后并发症总发生率为5.36%,明显低于对照组的26.79%,差异有统计学意义(P<0.05)。结论病灶切除联合子宫动脉结扎术治疗瘢痕妊娠临床疗效显著,且可有效降低患者术后并发症发生率,具有临床应用价值。
Objective To evaluate the clinical effect of focus resection combined with uterine artery ligation in the treatment of scar pregnancy.Methods A total of 112 patients of scar pregnancy admitted to Xi'an Labor Union Hospital from February 2017 to February 2018 were selected as the research objects.According to the random number table method,they were divided into observation group and control group,with 56 patients in each group.The control group was treated with hysteroscopic focus resection,and the observation group was treated with hysteroscopic focus resection combined with laparoscopic uterine artery ligation.The clinical efficacy,operation time,intraoperative blood loss,length of hospital stay,treatment cost,postoperative complications,recovery time of human chorionic gonadotropin(hCG),and menstrual recovery time were compared between the two groups.Results The total effective rate of the observation group was 94.6%,which was significantly higher than 80.4%of the control group(P<0.05);the operation time,intraoperative blood loss,length of hospital stay,and treatment cost of the observation group were(60.0±5.8)min,(162.5±6.5)mL,(11.2±1.9)d,(1.5±0.6)×104 yuan,which were significantly higher than(50.8±6.0)min,(49.8±6.2)mL,(6.8±1.5)d,(0.9±0.4)×104 yuan of the control group.The hCG recovery time and menstrual recovery time of the observation group were(24.8±3.3)d and(31.9±3.2)d,respectively,which were significantly shorter than(32.9±3.9)d and(41.8±4.2)d of the control group(P<0.05).During the follow-up period of 2 years,the rates of re-pregnancy,adverse pregnancy outcome,and scar pregnancy in the observation group were 3.57%,1.78%,and 1.78%,respectively,which showed no significant difference with 1.78%,1.78%,and 3.57%in the control group(P>0.05).The total incidence of postoperative complications in the observation group was 5.36%,which was significantly lower than 26.79%of the control group(P<0.05).Conclusion Focus resection combined with uterine artery ligation is effective and safe in the treatment of scar pregnancy,which can effectively reduce the incidence of postoperative complications.
作者
王婧
张璐
李鑫
WANG Jing;ZHANG Lu;LI Xin(Department of Obstetrics and Gynecology,Xi'an Labor Union Hospital,Xi'an 710100,Shaanxi,CHINA;Department of Obstetrics,Baoji Hospital of Traditional Chinese Medicine,Baoji 721000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2020年第21期2772-2774,共3页
Hainan Medical Journal
关键词
瘢痕妊娠
病灶切除
子宫动脉结扎术
宫腔镜
腹腔镜
疗效
并发症
Scar pregnancy
Focus resection
Uterine artery ligation
Hysteroscopy
Laparoscopy
Efficacy
Complications
