子宫动脉栓塞术预处理后宫腔镜手术治疗子宫瘢痕妊娠的疗效分析
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摘要
目的观察子宫动脉栓塞术(UAE)预处理后宫腔镜手术治疗子宫瘢痕妊娠(CSP)的临床疗效。方法 100例CSP患者,随机分为观察组与对照组,每组50例。对照组患者采用传统清宫术治疗,观察组患者采用UAE颅处理后宫腔镜手术治疗,观察并比较两组患者手术时间、术中出血量及术后人绒毛膜促性腺激素(HCG)转阴时间、术后感染发生情况。结果观察组患者手术时间、术中出血量、术后HCG转阴时间分别为(62.25±1.40)min、(18.10±1.20)ml、(22.15±1.80)d,均优于对照组的(85.40±1.50)min、(27.15±2.20)ml、(45.15±1.20)d,差异具有统计学意义(P<0.05)。观察组患者术后感染发生率为2.00%(1/50),低于对照组的22.00%(11/50),差异具有统计学意义(χ~2=9.4697, P<0.05)。结论 UAE预处理后宫腔镜手术治疗CSP的疗效显著,能缩短手术时间,减少术中出血量,降低术后感染率,具有积极推广价值。
Objective To observe the clinical efficacy of hysteroscopy for the treatment of caesarean scar pregnancy(CSP) after uterine artery embolization(UAE) pretreatment. Methods A total of 100 CSP patients were randomly divided into observation group and control group,with 50 cases in each group.The control group was treated with traditional hysteroscopy and the observation group was treated with hysteroscopy after UAE pretreatment. Observation and comparison were made on operation time, intraopeative bleeding volume,postoperative negative conversion time of human chorionic gonadotropin(HCG) and occurrence of postoperative infection between the two groups. Results The observation group had better operation time, intraopeative bleeding volume, postoperative negative conversion time of HCG respectively as(62.25± 1.40) min,(18.10±1.20)ml and(22.15±1.80)d than(85.40± 1.50)min,(27.15±2.20)ml and(45.15± 1.20)d in the control group.Their difference was statistically significant(P<0.05).The observation group had lower incidence of postoperative infection as 2.00%(1/50) than 22.00%(11/50) in the control group,and the difference was statistically significant(χ~2=9.4697, P<0.05). Conclusion Hysteroscopy after UAE pretreatment shows remarkable efficacy in treating CSP, and it can shorten operation time, reduce intraoperative bleeding volume and lower postoperative infection rate. It contains positive promotion value.
Objective To observe the clinical efficacy of hysteroscopy for the treatment of caesarean scar pregnancy(CSP) after uterine artery embolization(UAE) pretreatment. Methods A total of 100 CSP patients were randomly divided into observation group and control group,with 50 cases in each group.The control group was treated with traditional hysteroscopy and the observation group was treated with hysteroscopy after UAE pretreatment. Observation and comparison were made on operation time, intraopeative bleeding volume,postoperative negative conversion time of human chorionic gonadotropin(HCG) and occurrence of postoperative infection between the two groups. Results The observation group had better operation time, intraopeative bleeding volume, postoperative negative conversion time of HCG respectively as(62.25± 1.40) min,(18.10±1.20)ml and(22.15±1.80)d than(85.40± 1.50)min,(27.15±2.20)ml and(45.15± 1.20)d in the control group.Their difference was statistically significant(P<0.05).The observation group had lower incidence of postoperative infection as 2.00%(1/50) than 22.00%(11/50) in the control group,and the difference was statistically significant(χ~2=9.4697, P<0.05). Conclusion Hysteroscopy after UAE pretreatment shows remarkable efficacy in treating CSP, and it can shorten operation time, reduce intraoperative bleeding volume and lower postoperative infection rate. It contains positive promotion value.
引文
[1]韩丽萍,胡庆红,Hada Abha,等.子宫动脉栓塞术后宫腹腔镜联合治疗瘢痕妊娠的临床研究.中国妇幼保健,2016,31(4):874-876.
[2]梁家彬,胡杰.子宫动脉栓塞术联合宫腔镜下瘢痕妊娠清除术治疗瘢痕妊娠的疗效.中国疗养医学,2017,26(9):956-957.
[3]蒋花香.子宫动脉栓塞术后宫腹腔镜手术与TCSPDS-MN治疗子宫瘢痕妊娠的对比研究.临床医学工程,2018,22(6):126-127.
[4]付熙,苏晶,丁岩.子宫动脉栓塞术联合宫腔镜治疗在剖宫产瘢痕妊娠治疗中的应用价值.中国妇产科临床杂志,2016,16(3):252-254.
[5]王素华.剖宫产切口瘢痕妊娠患者采用宫腔镜及子宫动脉栓塞术联合治疗的效果及安全性分析.中国内镜杂志,2016,22(9):84-87.
[6]李元宏.宫腔镜联合子宫动脉栓塞术终止剖宫产术后子宫瘢痕妊娠的疗效与安全性.医药前沿,2016,6(16):238-239.
[7]余燕,孔丽梅,安静.宫腔镜联合子宫动脉栓塞术终止剖宫产术后子宫瘢痕妊娠的疗效与安全性.大家健康(学术版),2016,6(3):108-109.
[8]汪永平,胡红文,温勇坚,等.子宫动脉栓塞术在综合治疗高风险子宫瘢痕妊娠中的作用.中国介入影像与治疗学,2016(1):21-24.
[9]任冉.剖宫产切口瘢痕妊娠患者行宫腔镜联合子宫动脉栓塞术治疗的临床疗效观察.中国妇幼保健,2016,31(23):4992-4995.
[10]顾玉婵,赵蓉,田彪,等.腹腔镜联合子宫动脉栓塞术治疗外生型剖宫产瘢痕妊娠的疗效.武警医学,2016,27(4):356-358.
[11]王文芳,陈秀慧,王德莹,等.宫腔镜联合子宫动脉栓塞术在剖宫产切口瘢痕妊娠中应用的可行性分析.实用妇产科杂志,2013,29(11):840-843.
[12]罗团团.腹腔镜联合子宫动脉栓塞术治疗外生型剖宫产瘢痕妊娠的疗效.医学理论与实践,2018,31(11):1657-1658.
[13]王远航,韩宇宁,刘佳,等.子宫动脉栓塞术后经阴道与经宫腔镜治疗外生型剖宫产瘢痕妊娠临床疗效分析.现代生物医学进展,2017(6):95-98.
[14]王光伟,刘晓菲,王丹丹,等.选择性子宫动脉栓塞术联合宫腔镜手术治疗外生型剖宫产术后子宫瘢痕妊娠67例临床分析.中华妇产科杂志,2015(8):576-581.
[15]刚君,高万里,宋风丽,等.选择性子宫动脉栓塞术联合宫腔镜手术治疗外生型剖宫产术后子宫瘢痕妊娠的疗效观察.医学临床研究,2017,34(7):1390-1392.
[2]梁家彬,胡杰.子宫动脉栓塞术联合宫腔镜下瘢痕妊娠清除术治疗瘢痕妊娠的疗效.中国疗养医学,2017,26(9):956-957.
[3]蒋花香.子宫动脉栓塞术后宫腹腔镜手术与TCSPDS-MN治疗子宫瘢痕妊娠的对比研究.临床医学工程,2018,22(6):126-127.
[4]付熙,苏晶,丁岩.子宫动脉栓塞术联合宫腔镜治疗在剖宫产瘢痕妊娠治疗中的应用价值.中国妇产科临床杂志,2016,16(3):252-254.
[5]王素华.剖宫产切口瘢痕妊娠患者采用宫腔镜及子宫动脉栓塞术联合治疗的效果及安全性分析.中国内镜杂志,2016,22(9):84-87.
[6]李元宏.宫腔镜联合子宫动脉栓塞术终止剖宫产术后子宫瘢痕妊娠的疗效与安全性.医药前沿,2016,6(16):238-239.
[7]余燕,孔丽梅,安静.宫腔镜联合子宫动脉栓塞术终止剖宫产术后子宫瘢痕妊娠的疗效与安全性.大家健康(学术版),2016,6(3):108-109.
[8]汪永平,胡红文,温勇坚,等.子宫动脉栓塞术在综合治疗高风险子宫瘢痕妊娠中的作用.中国介入影像与治疗学,2016(1):21-24.
[9]任冉.剖宫产切口瘢痕妊娠患者行宫腔镜联合子宫动脉栓塞术治疗的临床疗效观察.中国妇幼保健,2016,31(23):4992-4995.
[10]顾玉婵,赵蓉,田彪,等.腹腔镜联合子宫动脉栓塞术治疗外生型剖宫产瘢痕妊娠的疗效.武警医学,2016,27(4):356-358.
[11]王文芳,陈秀慧,王德莹,等.宫腔镜联合子宫动脉栓塞术在剖宫产切口瘢痕妊娠中应用的可行性分析.实用妇产科杂志,2013,29(11):840-843.
[12]罗团团.腹腔镜联合子宫动脉栓塞术治疗外生型剖宫产瘢痕妊娠的疗效.医学理论与实践,2018,31(11):1657-1658.
[13]王远航,韩宇宁,刘佳,等.子宫动脉栓塞术后经阴道与经宫腔镜治疗外生型剖宫产瘢痕妊娠临床疗效分析.现代生物医学进展,2017(6):95-98.
[14]王光伟,刘晓菲,王丹丹,等.选择性子宫动脉栓塞术联合宫腔镜手术治疗外生型剖宫产术后子宫瘢痕妊娠67例临床分析.中华妇产科杂志,2015(8):576-581.
[15]刚君,高万里,宋风丽,等.选择性子宫动脉栓塞术联合宫腔镜手术治疗外生型剖宫产术后子宫瘢痕妊娠的疗效观察.医学临床研究,2017,34(7):1390-1392.