摘要
目的:分析经阴道妊娠病灶切除术和子宫动脉栓塞术(UAE)联合刮宫术治疗剖宫产瘢痕妊娠(CSP)II、III型临床疗效。方法:选取2017年3月—2023年1月本院收治的Ⅱ型、Ⅲ型CSP患者77例,随机分为两组,分别给予经阴道妊娠病灶切除术(经阴道组,36例),UAE联合刮宫术(UAE组,41例)。比较两组治疗成功率、住院费用及时间、人绒毛膜促性腺激素(hCG)恢复至正常时间、术中出血量、术后首次月经复潮时间、并发症、术后疼痛等。结果:经阴道组治疗成功率(100.0%)、术中出血量(24.4±13.9ml)、住院时间(7.3±1.7d)与UAE组(97.6%、22.4±8.6ml、7.0±2.1d)无差异(P>0.05),住院费用(10808.3±2310.7元)、血清hCG下降至正常时间(16.0±3.6d)、月经恢复时间(30.3±2.1d)、并发症发生率(0)、患者术后疼痛评分(4.72±1.67分)均低于UAE组(16888.7±4004.5元、18.4±3.0d、32.8±4.6d、9.8%、7.89±1.41分)(均P<0.05)。结论:两种方法治疗效果相当,但经阴道妊娠病灶切除术术后恢复指标更佳,并发症更低。
Objective:To explore the clinical effect of transvaginal pregnant lesion resection(TPLR)or uterine artery embolization(UAE)combined with curettage for treating patients with type II or type III of cesarean scar pregnancy(CSP).Methods:77patients with type II or III CSP were selected and were randomly divided into two groups from March 2017to January 2023.36patients in the observation group were treated with TPLR,and 41patients in the control group were treated with UAE combined with curettage.The treatment success rate,the hospital expenses,the time of hospital stay,the time of human chorionic gonadotropin(hCG)value returned to the normal range,the total amount of bleeding during the operation,the time of the first menstrual cycle recovery after the operation,the incidence of complications,and the pain score after the operation of the patients were compared between the two groups.Results:There were no significant differences in the treatment success rate(100.0%vs.97.6%),the intraoperative blood loss(24.4±13.9ml vs.22.4±8.6ml),and the time of hospital stay(7.3±1.7dvs.7.0±2.1d)of the patients between the two groups(P>0.05).The hospitalization cost(10808.3±2310.7yuan),the time of serum hCG level turn to normal range(16.0±3.6d),the menstrual recovery time(30.3±2.1d),the complication rate(0),and the postoperative pain score(4.72±1.67points)of the patients in the observation group were all significantly lower than those(16888.7±4004.5yuan,18.4±3.0d,32.8±4.6d,9.8%,and 7.89±1.41min)of the patients in the control group(all P<0.05).Conclusion:TPLR and UAE combined with curettage for treating the patients with type II or type III CSP have the same therapeutic effectiveness,but TPLR has better recovery and fewer complications after operation.
作者
闫海燕
王梅
YAN Haiyan;WANG Mei(People's Hospital of Pudong New Area,Shanghai,201299)
出处
《中国计划生育学杂志》
2023年第7期1518-1521,共4页
Chinese Journal of Family Planning
基金
上海市浦东新区卫健委重点学科(PWZxk2022-28)。
关键词
剖宫产瘢痕妊娠
经阴道妊娠病灶切除术
子宫动脉栓塞术
治疗效果
术后恢复
并发症
Cesarean scar pregnancy
Transvaginal pregnant lesion resection
Uterine artery embolization
Therapeutic effect
Postoperative recovery
Complication
