首页|子宫动脉栓塞术联合超声引导下清宫术治疗子宫瘢痕妊娠的临床分析

子宫动脉栓塞术联合超声引导下清宫术治疗子宫瘢痕妊娠的临床分析

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目的 探讨子宫动脉栓塞术(UAE)联合超声引导下清宫术治疗Ⅱ型、Ⅲ型子宫瘢痕妊娠(CSP)的临床效果.方法 回顾性分析我院收治的90例CSP患者的临床资料,根据术前阴道彩超表现将患者分为Ⅱ型组和Ⅲ型组.2组患者均行UAE联合超声引导下清宫术治疗.比较分析2组患者术中及术后情况.结果 Ⅱ型组的治愈率(92.5%)高于Ⅲ型组(65.2%),Ⅱ型组患者术中阴道出血量、术后血清β-hCG转阴时间、术后病灶消退时间均少/短于Ⅲ型组,差异有统计学意义(P<0.05);2组患者住院时间及月经复潮时间比较,差异无统计学意义(P>0.05).结论 对于孕周8~10周的Ⅱ型CSP患者,UAE联合超声引导下清宫术的治疗效果理想,可作为推荐的治疗方案.但对于Ⅲ型CSP患者,UAE联合超声引导下清宫术的治愈率较低,应考虑患者具体情况及当地医疗水平等综合选择.
Clinical analysis of uterine artery embolization combined with ultrasound-guided curettage in treatment of caesarean scar pregnancy
Objective To evaluate the efficacy of uterine artery embolization(UAE)combined with ultrasound-guided curettage in the treatment of type Ⅱ and type Ⅲ caesarean scar pregnancy(CSP).Methods The clinical data of 90 patient with CSP in our hospital were analyzed retrospectively,the patients were divided into type Ⅱ group and type Ⅲ group according to preoperative vaginal color Doppler ultrasound.Patients in both groups were treated with UAE combined with ultrasound-guided curettage.The intraoperative and postoperative conditions of patients between the two groups were compared and analyzed.Results The cure rate of type Ⅱ group(92.5%)was higher than that of type Ⅲ group(65.2%),the intraoperative blood loss,time of postoperative serum β-hCG turned negative,postoperative mass disappearance time of patients in type Ⅱ group were less/shorter than those in type Ⅲ group,the differences were statistically significant(P<0.05);there was no statistical difference in length of hospitalization or time to menstruation recovery of patients between the two groups(P>0.05).Conclusion UAE combined with ultrasound-guided curettage is ideal for patients with type Ⅱ CSP at 8 to 10 weeks of gestation,and can be used as a recommended treatment.However,the cure rate of this method for type Ⅲ CSP is low,the comprehensive choice should be considered,including the specific situation of the patient and the local medical level.

cesarean scar pregnancyuterine artery embolizationultrasound-guided curettagetransvaginal color Doppler ultrasound

王文珍、魏凌云、温亚玲、刘小春

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山西白求恩医院(山西医学科学院)/同济山西医院/山西医科大学第三医院妇产科,山西太原 030032

子宫瘢痕妊娠 子宫动脉栓塞术 超声引导下清宫术 经阴道超声

国家自然科学基金面上项目山西省回国留学人员科研教研资助项目山西省留学人员科技活动择优资助

81971365HGKY201909520200007

2024

局解手术学杂志
重庆市解剖学会,第三军医大学

局解手术学杂志

CSTPCD
影响因子:1.063
ISSN:1672-5042
年,卷(期):2024.33(8)
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