| 王远航 韩宇宁 刘佳 芦维园 卢美松 柳英兰△.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[J].,2017,17(6):1086-1089 |
| 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 |
| Analysis of the Clinical Efficacy of Transvaginal and Hysteroscopy afterUterine Artery Embolization in the Treatment of Cesarean Scar Pregnancy |
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| DOI： |
| 中文关键词: 剖宫产瘢痕妊娠 子宫动脉栓塞 宫腔镜手术 阴式手术 |
| 英文关键词: Cesarean scar pregnancy Uterine artery embolization Hysteroscopy Transvaginal surgery |
| 基金项目:黑龙江省自然科学基金重点项目（ZD201110）；黑龙省教育厅课题（1252233） |
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| 中文摘要: |
| 目的：探讨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(CSP)的临床疗效。方法：回顾性分析2013 年10
月至2015 年5 月哈尔滨医科大学附属第一医院收治的56例确诊为外生型CSP患者的临床资料，其中26例行子宫动脉栓塞术
后经阴道切除外生型瘢痕妊娠病灶(经阴道手术组)，30 例行子宫动脉栓塞术后经宫腔镜切除外生型瘢痕妊娠病灶(经宫腔镜手术
组)。比较两组患者的手术成功率、术中出血量、术后住院时间、住院费用、血HCG 下降至正常时间及不良反应的发生情况等。结
果：经阴道手术组26 例患者手术全部成功，成功率为100 %。经宫腔镜手术组30例患者中22例手术成功，8 例因术中子宫穿孔
改行腹腔镜或经腹外生型瘢痕妊娠病灶切除及子宫修补，成功率为73.3 %，显著低于经阴道手术组，差异有统计学意义(P<0.05)。
经阴道手术组患者的术中出血量[(20.58± 6.1)mL]及住院费用((8833.04± 491.5)元)明显低于经宫腔镜手术组[(69.03± 7.8)mL]
(P＜0.001)、(14908.79± 325.5)元(P＜0.001)。结论：子宫动脉栓塞术后经阴道与经宫腔镜两种术式均能达到较理想的治疗效果；经
阴道治疗外生型CSP可行性强于经宫腔镜手术，更安全、有效；值得临床推广。 |
| 英文摘要: |
| Objective:To investigate the clinical effect of transvaginal and hysteroscopy on the type Ⅱ cesarean scar pregnancy
(CSP) after uterine artery embolization.Methods:The clinical data of 56 cases of patients diagnosed as type Ⅱ CSP in First Affiliated
Hospital of Harbin Medical University from October 2013 to May 2015 were retrospectively analyzed, including 26 cases underwent
transvaginal operation after uterine artery embolization ( Transvaginal Operation group) and 30 cases underwent hysteroscopy after
uterine artery embolization (Hysteroscopy group). The success rate of operation, intraoperation bleeding, postoperation hospital stay,
hospitalization expenses, the time beta-HCG decreased to normal and adverse reaction occurred in both groups were compared.Results:The operation of transvaginal group was completely successful in 26 patients, and the success rate was 100%. The operation of
hysteroscopy group was successful in 22 cases, 8 cases was converted to laparoscopic or abdominal operation excision and repair of
uterine scar because of uterine perforation intraoperation, the success rate was 73.3%, which was significantly lower than the transvaginal
group (P<0.05). The intraoperation bleeding and the hospitalization expenses in transvaginal operation group were ((20.58± 6.1)ml), (
(8833.04± 491.5)yuan), which were both significantly lower than those ((69.03± 7.8)mL), ((14908.79± 325.5)yuan) of the hysteroscopy
group (P＜0.001).Conclusion:Both transvaginal operation and hysteroscopic after uterine artery embolization could achieve the ideal
therapeutic effect; the treatment of type Ⅱ CSP by transvaginal operation was more safe and effective than hysteroscopy. It was worth
clinical promotion. |
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