摘要
目的探讨子宫动脉暂时阻断在剖宫产术后瘢痕妊娠(cesarean scar pregnancy,CSP)中的应用价值。方法选取深圳市中西医结合医院2019年5月至2021年5月收治的经阴道超声考虑Ⅱ型及Ⅲ型并行MRI三维重建明确诊断为Ⅱ型及Ⅲ型CSP患者60例,采用随机数字表法将其分为实验组与对照组各30例。其中腹腔镜下子宫动脉暂时阻断后行剖宫产瘢痕妊娠病灶去除术组为实验组,直接行剖宫产瘢痕妊娠病灶去除术为对照组,比较两组患者治疗成功率、手术时间、术中出血量,住院时间,不良反应,术后3个月子宫内膜厚度及子宫内膜血运情况。结果实验组和对照组住院时间分别为(7.3±3.3)d、(8.9±4.2)d;住院费用为(13566.3±1967.2)元、(14250.3±1639.1)元;治疗不良反应发生率分别为16.7%、33.3%;两组患者治疗成功率分别为97.6%、73.3%,术中出血量分别为(125.3±35.2)mL、(423.3±67.2)mL,以上比较差异均有统计学意义(P<0.05),术后3个月子宫内膜厚度分别为(8.3±1.4)mm、(8.5±1.2)mm,手术时间分别为(94.7±15.2)min、(91.3±16.4)min,以上两项比较差异无统计学意义(P>0.05)。相较于对照组,实验组成功率较高、治疗不良反应较少、术中出血量较少、实验组明显优于对照组(P<0.05)。并且手术时间无影响,术后3个月排卵期阴超测量子宫内膜厚度及子宫内膜血运无影响。结论腹腔镜下子宫动脉暂时阻断治疗CSP安全性高,术后并发症及近远期不良反应少,值得推荐。
Objective To investigate the application value of uterine artery temporary blocking in cesarean scar pregnancy(CSP).Methods Sixty patients admitted to Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine from May 2019 to May 2021 diagnosed as type Ⅱ and type Ⅲ CSP by transvaginal ultrasonography and concurrent MRI three-dimensional reconstruction were selected.Random number table method was used to divide them into experimental group and control group,30 cases each.The treatment success rate,operation time,intraoperative blood loss,length of hospital stay,side effects,endometrial thickness and endometrial blood flow 3 months after operation were compared between the two groups.Results The hospital stay of the experimental group and the control group were(7.3±3.3)d and(8.9±4.2)d,respectively.The hospitalization expenses were(13566.3±1967.2)yuan and(14250.3±1639.1)yuan.The incidence of side effects were 16.7%and 33.3%,respectively.The treatment success rates of the two groups were 97.6%and 73.3%,respectively.The intraoperative blood loss was(125.3±35.2)mL and(423.3±67.2)mL,respectively.The differences were statistically significant(P<0.05),the endometrial thickness was(8.3±1.4)mm and(8.5±1.2)mm,respectively.The operation time was(94.7±15.2)min and(91.3±16.4)min,respectively.There was no statistically significant difference between the two comparisons(P>0.05).Compared with the control group,the experimental group had higher success rate,less side effects and less intraoperative blood loss,and the experimental group was significantly better than the control group(P<0.05).Moreover,the operation time had no effect,and the endometrial thickness and endometrial blood flow measured by vaginal overmeasurement during ovulation 3 months after the operation had no effect.Conclusion Laparoscopic temporary blockage of uterine artery in the treatment of caesarean section scar pregnancy safety is high,postoperative complications and short-and long-term side effects are less,worthy of recommendation.
作者
刘琼芬
生秀杰
吕永革
沈琳
王炎
Liu Qiongfen;Sheng Xiujie;Lu Yongge;Shen Lin;Wang Yan(Department of Gynecology,Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine;Department of Gynecology,the Third Affiliated Hospital of Guangzhou Medical University,Shenzhen Guangdong 518104,P.R.China)
出处
《中国计划生育和妇产科》
2023年第4期76-78,共3页
Chinese Journal of Family Planning & Gynecotokology
基金
深圳市宝安区医疗卫生基础研究项目(项目编号:2020JD066)
深圳市“医疗卫生三名工程”项目资助(项目编号:SZZYSM202106003)。
关键词
剖宫产瘢痕妊娠
子宫动脉暂时阻断
子宫内膜厚度
子宫内膜血运
scar pregnancy
temporary blockage of uterine artery
endometrial thickness
endometrial blood transport
