3种方案用于剖宫产瘢痕妊娠药物治疗大出血的对比观察

目的探讨单纯水囊压迫、急诊刮宫+水囊压迫及B超引导下吸宫+选择性水囊压迫3种方案用于剖宫产瘢痕妊娠药物治疗大出血后患者的临床效果及安全性。方法选取淄博市临淄区人民医院2012年2月至2015年2月收治的剖宫产瘢痕妊娠药物治疗大出血患者130例,其中行单纯水囊压迫治疗21例为A组,行急诊刮宫+水囊压迫治疗30例为B组,行B超引导下吸宫+选择性水囊压迫79例为C组。观察3组手术时间、围手术期出血量、住院时间、血β-人绒毛膜促性腺激素(human chorionic gonadotrophin,HCG)术后降至正常时间及并发症发生率等。结果 3组患者手术时间比较差异无统计学意义(P0.05);C组患者围手术期出血量、住院时间及血β-HCG术后降至正常时间均优于A、B组(P0.05);C组患者并发症发生率低于A、B组(P0.05)。结论 B超引导下吸宫+选择性水囊压迫治疗方案用于剖宫产瘢痕妊娠治疗效果及安全性均显著优于单纯水囊压迫、急诊刮宫+水囊压迫两种方案,具有临床应用价值。

Comparative observation of three kinds of therapeutic schemes in the treatment of cesarean scar pregnancy with massive hemorrhage after medication

Objective To investigate the clinical effects and safety differences of three kinds of therapeutic schemes ( water sac compression used alone, emergency suction palace + water sac compression and suction palace guided by B ultrasound + selective water sac compression) in the treatment of cesarean scar pregnancy with massive hemorrhage after medication. Methods 130 patients with cesarean scar pregnancy with massive hemorrhage after medication were chosen in the period from February 2012 to February 2015 in the People's Hospital of Linzi District,and they were divided into 3 groups including A group (21 patients) with water sac compression used alone after massive hemorrhage by drug treatment, B group (30 patients) with emergency suction palace + water sac compression after massive hemorrhage by drug treatment and C group (79 patients) with suction palace guided by B ultrasound + selective water sac compression. The operation time, perioperative bleeding volume, hospitalization time, time of postoperative serum β - HCG decreased to normal and the incidence of complications of 3 groups were compared. Results There was no significant difference in operation time among 3 groups (P>0. 05). The perioperative bleeding volume, hospitalization time and time of postoperative serumβ-HCG decreased to normal of group C was significantly better than group A and group B(P<0. 05). The incidence of complications of group C was significantly lower than group A and group B ( P<0. 05 ) . Conclusion Compared with water sac compression used alone and emergency suction palace + water sac compression, suction palace guided by B ultrasound + selective water sac compression in the treatment of cesarean scar pregnancy with massive hemorrhage after medication possess better clinical effects and safety.