探讨子宫动脉栓塞术联合宫腔镜手术治疗外生型剖宫产术后子宫瘢痕妊娠的临床疗效

目的探讨子宫动脉栓塞术联合宫腔镜手术治疗外生型剖宫产术后子宫瘢痕妊娠的临床疗效。方法选取2018年1月～2019年1月外生型CSP患者200例,依据随机数字表法分成两组,每组各100例。对照组给予甲氨蝶呤肌肉注射加宫腔镜下清宫术治疗,观察组则给予UAE联合宫腔镜手术治疗,比较两组子宫瘢痕处的包块消失时间、月经恢复时间、术中出血量、住院时间、不良反应率、治疗成功率及总有效率。结果观察组包块消失时间(50.75±5.50)d、月经恢复时间(30.12±3.20)d、住院时间(6.12±1.52)d、术中出血量(30.42±6.02)mL,对照组包块消失时间(75.40±5.23)d、月经恢复时间(50.41±3.75)d、住院时间(14.17±1.74)d、术中出血量(70.41±6.82)mL,观察组临床指标均优于对照组,差异有统计学意义(P0.05);观察组患者的不良反应率为3.00%,低于对照组的15.00%,差异有统计学意义(P0.05);观察组治疗成功率为98.00%,高于对照组的85.00%,差异有统计学意义(P0.05);观察组治疗总有效率为95.00%,高于对照组的78.00%,差异有统计学意义(P0.05)。结论给予UAE联合宫腔镜手术治疗外生型CSP可提高治疗有效率,术后恢复快,可以在临床推广使用。

The clinical efficacy of uterine artery embolization combined with hysteroscopic surgery on uterine scar pregnancy after exogenous cesarean section

Objective To investigate the clinical efficacy of uterine artery embolization combined with hysteroscopic surgery on uterine scar pregnancy after exogenous cesarean section.Methods A total of 200 patients with exogenous CSP who were admitted from January 2018 to January 2019.According to the principle of random number table,they were divided into two groups,with 100 cases in each group.The control group was received methotrexate intramuscular injection plus hysteroscopic uterine curettage.And the observation group was received UAE combined with hysteroscopic surgery.The mass disappearance time of uterine scars,menstrual recovery time,intraoperative blood loss,hospitalization time,adverse reaction rate,treatment success rate and total effective rate in two groups were compared.Results The mass disappearance time (50.75±5.50)d,menstrual recovery time (30.12±3.20)d,hospitalization time (6.12±1.52)d and intraoperative blood loss (30.42±6.02)mL in the observation group.The mass disappearance time (75.40±5.23)d,menstrual recovery time (50.41±3.75)d,hospitalization time (14.17±1.74)d and intraoperative blood loss (70.41±6.82)mL in the control group.The clinical indexes of the observation group were better than those of the control group,and the difference was statistically significant (P<0.05).The adverse reaction rate of the observation group was 3.00%,lower than that of the control group (15.00%),and the difference was statistically significant (P<0.05).The total treatment success rate of the observation group was 98.00%,higher than that of the control group (85.00%),and the difference was statistically significant (P<0.05).The total effective rate of the observation group was 95.00%,higher than that of the control group (78.00%),and the difference was statistically significant (P<0.05).Conclusion UAE combined with hys teroscopic surgery for exogenous CSP can improve the efficiency of treatment,with quick recovery,and can be promoted and used in clinic.