剖宫产瘢痕子宫妊娠患者应用宫腔镜下清宫术联合UAE的治疗效果分析及其预后质量的影响(1)
【摘要】 目的：探讨剖宫产瘢痕子宫妊娠患者应用宫腔镜下清宫术联合子宫动脉栓塞(UAE)的治疗效果分析及其预后质量的影响。方法：选取2016年1月-2017年2月到本院进行治疗的400例剖宫产瘢痕子宫患者为研究对象，按照随机分组的方式将其分为对照组和研究组两组，每组各200例。对照组患者应用常规宫腔镜清宫术进行治疗，研究组患者应用宫腔镜下清宫术联合UAE进行治疗。结果：治疗前两组患者体内β-hCG水平以及病灶最大直径无明显区别(P>0.05)，治疗后研究组患者β-hCG水平显著低于对照组患者，同时病灶最大直径也显著低于对照组患者(P<0.05)；对照组患者术中出血量、手术时间以及住院天数均显著高于研究组患者(P<0.05)；研究组患者hCG降至正常时间、病灶消失时间以及月经复潮时间均显著短于对照组患者(P<0.05)；研究组患者并发症出现率显著低于对照组患者(P<0.05)。结论：本院在对剖宫产瘢痕子宫妊娠患者的治疗中发现，患者应用宫腔镜下清宫术联合UAE治疗效果理想，在临床上应当进一步推广应用。
【关键词】 剖宫产； 瘢痕子宫； 子宫动脉栓塞
【Abstract】 Objective：To investigate the effect of hysteroscopy and uterine arterial embolization (UAE) on the treatment of uterine pregnancy with cesarean section.Method：400 patients with scar uterus who underwent cesarean section from January 2016 to February 2017 were treated as subjects，they were divided into control group and study group according the random number table method，200 cases in each group.The control group was treated with routine hysteroscopy.The study group was treated with hysteroscopy and UAE.Result：Before treatment，there were no significant differences in two groups of β-hCG level and maximal diameter(P>0.05)；after treatment，the maximal diameter and β-hCG level in study group were significantly lower than those of the control group(P<0.05).The intraoperative bleeding， operation time and hospitalization days of control group were significantly higher than those in the study group(P<0.05).In the study group，hCG decreased to normal time，lesion disappearance time and menstrual cycle time were significantly shorter than those in control group(P<0.05).The incidence of complications in the study group was significantly lower than that in the control group(P<0.05).Conclusion：In the treatment of uterine scar uterus in cesarean section，we found that patients with hysteroscopy and UAE are the ideal for the treatment，it should be further popularized in clinical practice.
【Key words】 Cesarean section； Scar uterus； Uterine arterial embolization
First-author’s address：PLA No.184 Hospital，Yingtan 335000，China
doi：10.3969/j.issn.1674-4985.2018.31.007
瘢痕妊娠是指有過剖宫产史的患者再次受孕时，孕囊或胚胎组织着床在前次剖宫产留下的瘢痕处，威胁胎儿生命以及母体自身健康的一种异位妊娠疾病，在临床上虽较为罕见，但危害性极大[1]。本院在对剖宫产瘢痕子宫妊娠患者的治疗中发现，患者应用宫腔镜下清宫术联合UAE治疗效果理想，现报道如下。
1 资料与方法
1.1 一般资料 选取2016年1月-2017年2月到本院进行治疗的400例剖宫产瘢痕子宫患者为研究对象，按照随机分组的方式将其分为对照组和研究组两组。纳入标准：确诊为瘢痕妊娠的所有患者[2]；所有腹痛、阴道不规则出血、停经以及有过剖宫产史的患者；所有血清β-hCG异常或者尿液hCG检测呈阳性的患者；所有经阴道B超检测确诊为子宫峡部的患者[3]；所有存在可见子宫手术瘢痕且超声诊断呈现不均匀回声的患者；经检查所有宫颈管内未发现妊娠囊，子宫附件内未发现包块的患者；所有知情并同意配合的患者[4]。排除标准：除瘢痕妊娠外合并其他类型异位妊娠的患者[5]；经检查身体状况不符合本研究标准的患者；肝肾功能严重不全合并其他严重内脏疾病的患者[6]；患有精神类疾病或不能正常进行交流的患者；因各种原因未完整参与整个研究的患者；对本研究所用药物过敏的患者[7]。本研究已经过医院伦理委员会批准。, http://www.100md.com(叶春杰 祝晓丽)
【关键词】 剖宫产； 瘢痕子宫； 子宫动脉栓塞
【Abstract】 Objective：To investigate the effect of hysteroscopy and uterine arterial embolization (UAE) on the treatment of uterine pregnancy with cesarean section.Method：400 patients with scar uterus who underwent cesarean section from January 2016 to February 2017 were treated as subjects，they were divided into control group and study group according the random number table method，200 cases in each group.The control group was treated with routine hysteroscopy.The study group was treated with hysteroscopy and UAE.Result：Before treatment，there were no significant differences in two groups of β-hCG level and maximal diameter(P>0.05)；after treatment，the maximal diameter and β-hCG level in study group were significantly lower than those of the control group(P<0.05).The intraoperative bleeding， operation time and hospitalization days of control group were significantly higher than those in the study group(P<0.05).In the study group，hCG decreased to normal time，lesion disappearance time and menstrual cycle time were significantly shorter than those in control group(P<0.05).The incidence of complications in the study group was significantly lower than that in the control group(P<0.05).Conclusion：In the treatment of uterine scar uterus in cesarean section，we found that patients with hysteroscopy and UAE are the ideal for the treatment，it should be further popularized in clinical practice.
【Key words】 Cesarean section； Scar uterus； Uterine arterial embolization
First-author’s address：PLA No.184 Hospital，Yingtan 335000，China
doi：10.3969/j.issn.1674-4985.2018.31.007
瘢痕妊娠是指有過剖宫产史的患者再次受孕时，孕囊或胚胎组织着床在前次剖宫产留下的瘢痕处，威胁胎儿生命以及母体自身健康的一种异位妊娠疾病，在临床上虽较为罕见，但危害性极大[1]。本院在对剖宫产瘢痕子宫妊娠患者的治疗中发现，患者应用宫腔镜下清宫术联合UAE治疗效果理想，现报道如下。
1 资料与方法
1.1 一般资料 选取2016年1月-2017年2月到本院进行治疗的400例剖宫产瘢痕子宫患者为研究对象，按照随机分组的方式将其分为对照组和研究组两组。纳入标准：确诊为瘢痕妊娠的所有患者[2]；所有腹痛、阴道不规则出血、停经以及有过剖宫产史的患者；所有血清β-hCG异常或者尿液hCG检测呈阳性的患者；所有经阴道B超检测确诊为子宫峡部的患者[3]；所有存在可见子宫手术瘢痕且超声诊断呈现不均匀回声的患者；经检查所有宫颈管内未发现妊娠囊，子宫附件内未发现包块的患者；所有知情并同意配合的患者[4]。排除标准：除瘢痕妊娠外合并其他类型异位妊娠的患者[5]；经检查身体状况不符合本研究标准的患者；肝肾功能严重不全合并其他严重内脏疾病的患者[6]；患有精神类疾病或不能正常进行交流的患者；因各种原因未完整参与整个研究的患者；对本研究所用药物过敏的患者[7]。本研究已经过医院伦理委员会批准。, http://www.100md.com(叶春杰 祝晓丽)
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