宫腔镜电切术联合子宫动脉栓塞治疗难治性胎盘残留的临床效果

目的探讨宫腔镜电切术联合子宫动脉栓塞治疗产后难治性胎盘残留的临床效果。方法选取该院妇产科2017年8月-2018年8月收治的产后难治性胎盘残留患者50例。随机数字表法分为观察组25例和对照组25例。对照组给予米非司酮口服后常规清宫术治疗,观察组给予宫腔镜电切术联合子宫动脉栓塞治疗,将两组患者的治疗效果进行对比分析。结果观察组与对照组术中出血量分别为(12.52±3.49)和(38.00±6.12)ml,手术时间分别为(21.00±5.31)和(35.40±6.52)min,手术一次成功率分别为96.0%(24/25)和56.0%(14/25),术后阴道流血时间分别为(6.88±2.11)和(10.56±2.26)d,术后月经恢复时间分别为(30.20±2.84)和(40.32±4.48)d,差异均有统计学意义(P 0.05)。结论宫腔镜电切术联合子宫动脉栓塞治疗产后难治性胎盘残留,具有出血少、手术一次成功率高和术后恢复好等优势,为临床治疗难治性胎盘残留提供了新思路,开拓了新视野。

Clinical evaluation of hysteroscopic electric resection combined with uterine artery embolization for the treatment of refractory residual placenta

To study the clinical effect of hysteroscopic electric resection combined with uterine artery embolization in treatment of postpartum refractory residual placenta. Methods 50 cases of postpartum refractory residual placenta from August 2017 to August 2018 were selected. The random number method was divided into observation group (25 cases) and control group (25 cases). The control group was treated with traditional curettage after mifepristone orally and the observation group was treated with hysteroscopic electric resection after uterine artery embolization. The therapeutic effects of the two groups were compared and analyzed. Results The separately amount of bleeding during operation of the observation group and the control group was (12.52 ± 3.49) ml, (38.00 ± 6.12) ml, the operation time of the observation group and the control group was (21.00 ± 5.31) min, (35.40 ± 6.52) min respectively, the success rate of operation of the observation group and the control group was 96.0% (24/25), 56.0% (14/25) respectively, the time of vaginal bleeding after operation of the observation group and the control group was (6.88 ± 2.11) d, (10.56 ± 2.26) d respectively, and the menstrual recovery time after operation of the observation group and the control group was (30.20 ± 2.84) d, (40.32 ± 4.48) d respectively. All the differences were statistically significant (P < 0.05). Conclusion Hysteroscopic electric resection combined with uterine artery embolization for postpartum refractory residual placenta has the advantages of less bleeding, high success rate of operation and good recovery after operation, it provides a new idea for clinical treatment of refractory residual placenta and opens up a new horizon.