单纯子宫动脉介入栓塞治疗瘢痕妊娠的效果观察
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摘要
目的观察单纯子宫动脉介入栓塞辅助治疗子宫瘢痕妊娠的效果。方法采用回顾性调查研究方法,选择2011年7月-2018年2月在医院确诊的子宫切口瘢痕妊娠患者62例,按照不同的治疗方法将其分为介入治疗组和传统治疗组各31例,传统治疗组在肌内注射药物将异位胚胎杀死的基础上进行刮宫治疗,介入治疗组则采用单纯子宫动脉介入栓塞并通过此通道灌注药物后再进行刮宫治疗。比较2组出血量,HCG及孕酮浓度下降比例、住院时间治疗费用及栓塞后综合征。结果介入治疗组出血量少于传统治疗组,血HCG及孕酮浓度的下降比例大于传统治疗组,术后住院时间短于传统治疗组,治疗费用高于传统治疗组,差异均有统计学意义(P <0. 05)。介入治疗组患者栓塞后综合征发生率为16. 13%,传统治疗组无栓塞后综合征发生。结论单纯子宫动脉介入栓塞术治疗子宫瘢痕妊娠可显著减少患者术中出血量,缩短住院恢复时间,但同时会增加治疗费用并出现一些并发症。
Objective To observe the effect of simple uterine artery interventional embolization in treatment of uterine scar pregnancy. Methods Using retrospective research methods,62 patients with uterine incision scar pregnancy diagnosed in the hospital from July 2011 to February 2018 were enrolled. According to different treatment methods,the patients were divided into interventional therapy group and traditional treatment group,each of 31 cases. Traditional treatment group was treated with intramuscular injection of ectopic embryos on the basis of curettage. Interventional therapy group was treated with uterine artery interventional embolization and perfusion of drugs through this channel before curettage. The bleeding volume,HCG and progesterone concentrations,hospitalization time,and post-embolic syndrome were compared between two groups. Results The amount of bleeding in intervention therapy group was lower than that in traditional treatment group,the decrease of blood HCG and progesterone concentration was greater than traditional treatment group,and the postoperative hospital stay was shorter than traditional treatment group,the treatment cost was higher than that of traditional treatment group,and the difference was statistically significant( P < 0. 05). The incidence of post-embolic syndrome in interventional therapy group was 16. 13%. There was no post-embolic syndrome in traditional treatment group. Conclusion Simple uterine artery interventional embolization for the treatment of uterine scar pregnancy can significantly reduce the amount of intraoperative blood loss,shorten the hospital recovery time,but at the same time increase the cost of treatment and some complications.
Objective To observe the effect of simple uterine artery interventional embolization in treatment of uterine scar pregnancy. Methods Using retrospective research methods,62 patients with uterine incision scar pregnancy diagnosed in the hospital from July 2011 to February 2018 were enrolled. According to different treatment methods,the patients were divided into interventional therapy group and traditional treatment group,each of 31 cases. Traditional treatment group was treated with intramuscular injection of ectopic embryos on the basis of curettage. Interventional therapy group was treated with uterine artery interventional embolization and perfusion of drugs through this channel before curettage. The bleeding volume,HCG and progesterone concentrations,hospitalization time,and post-embolic syndrome were compared between two groups. Results The amount of bleeding in intervention therapy group was lower than that in traditional treatment group,the decrease of blood HCG and progesterone concentration was greater than traditional treatment group,and the postoperative hospital stay was shorter than traditional treatment group,the treatment cost was higher than that of traditional treatment group,and the difference was statistically significant( P < 0. 05). The incidence of post-embolic syndrome in interventional therapy group was 16. 13%. There was no post-embolic syndrome in traditional treatment group. Conclusion Simple uterine artery interventional embolization for the treatment of uterine scar pregnancy can significantly reduce the amount of intraoperative blood loss,shorten the hospital recovery time,but at the same time increase the cost of treatment and some complications.
引文
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[10]周丽.不同治疗方案对剖宫产术后瘢痕妊娠临床疗效以及安全性评价[J].中国计划生育和妇产科,2018,10(2):52-56.DOI:10.3969/j.issn.1674-4020.2018.02.15.
[2]牟燕琳,李涛.子宫动脉介入栓塞在子宫瘢痕妊娠中的应用[J].实用医院临床杂志,2017,14(3):50-52.DOI:10.3969/j.issn.1672-6170.2017.03.015.
[3]赵峰,李文胜,郎援疆.超选择子宫动脉介入栓塞治疗子宫瘢痕妊娠的临床应用和疗效分析[J].农垦医学,2017,39(3):226-228.DOI:10.3969/j.issn.1008-1127.2017.03.010.
[4]聂东云,陈素文.子宫动脉栓塞介入治疗对不同年龄段剖宫产瘢痕妊娠患者的影响[J].中国计划生育学杂志,2017,25(7):463-466.DOI:10.3969/j.issn.1004-8189.2017.07.008.
[5]胡静.子宫动脉介入化疗栓塞联合宫腔镜治疗剖宫产瘢痕妊娠68例护理体会[J].临床合理用药杂志,2017,10(26):174-176.DOI:10.15887/j.cnki.13-1389/r.2017.26.115.
[6]刘锦玉,徐斌,郭立文.子宫动脉栓塞介入后清宫术治疗瘢痕妊娠12例的护理[J].中外医学研究,2016,14(24):98-100.DOI:10.14033/j.cnki.cfmr.2016.24.055.
[7]胡惠.单纯子宫动脉栓塞与联合MTX灌注治疗瘢痕妊娠的疗效对比分析[J].实用妇科内分泌杂志(电子版),2017,4(19):4-6.DOI:10.3969/j.issn.2095-8803.2017.19.002.
[8]张鹂.放射介入下子宫动脉栓塞术联合吸宫术治疗剖宫产瘢痕部位妊娠的临床效果评价[J].中外医疗,2015,34(35):177-178.DOI:10.16662/j.cnki.1674-0742.2015.35.177.
[9]崔雪蓉.剖宫产术后子宫疤痕妊娠的临床诊治进展[J].疑难病杂志,2012,11(7):562-564.DOI:10.3969/j.issn.1671-6450.2012.07.035.
[10]周丽.不同治疗方案对剖宫产术后瘢痕妊娠临床疗效以及安全性评价[J].中国计划生育和妇产科,2018,10(2):52-56.DOI:10.3969/j.issn.1674-4020.2018.02.15.