摘要
目的分析高强度聚焦超声(high intensity focused ultrasound,HIFU)消融治疗剖宫产术后子宫瘢痕部位妊娠(cesarean scar pregnancy,CSP)的临床疗效,探讨其临床价值。方法选择本院妇产科2014年1月-2017年1月诊治的CSP患者,随机分为两组,观察组采用HIFU消融治疗,对照组采用子宫动脉栓塞术(uterine artery embolization,UAE)治疗,比较两组治疗效果。结果观察组与对照组各纳入42例;两组平均年龄、平均孕龄、体质量指数、剖宫产次数、孕囊直径以及临床分型构成比差异无统计学意义(P>0.05);观察组平均住院时间[(6.0±1.5)d vs(8.9±3.1)d]和平均治疗费用[(8 839.5±975.1)元vs(15 726.4±1 834.7)元]少于对照组(P均<0.05),术后血β-HCG降至正常时间[(42.3±16.2)d vs(28.7±8.0)d]长于对照组(P<0.05)。2组并发症发生率[21.4%(9例)vs 30.9%(13例)]和治疗成功率[88.1%(37例)vs 97.6%(41例)]差异无统计学意义(P>0.05)。结论 HIFU消融用于CSP患者的无创性治疗,安全性、有效性满意,同时花费少、住院时间短,远期疗效待观察。
Objective To analyze the clinical efficacy of high intensity focused ultrasound ablation（HIFU） in the treatment of cesarean scar pregnancy（CSP） and explore its value in clinical practice. Methods Eighty-four CSP patients diagnosed and treated in our department from January 2014 to January 2017 were selected and randomly divided into two groups. Patients in observation group were treated with HIFU ablation, and the control group was treated with uterine artery embolization（UAE）. The general data of cases in two groups were recorded and the clinical outcomes between two groups were compared. Results There was no significant difference between the two groups in age, gestational age, body mass index, number of caesarean section, gestational sac diameter, and clinical classification（P〉0.05）. The length of hospitalization and the average treatment cost of observation group were less than those of control group [（6.0±1.5） d vs（8.9±3.1） d, P〈0.05;（8 839.5±975.1） yuan vs（15 726.4±1 834.7） yuan, P〈0.05]. The time of blood β-HCG returned to the normal in the observation group was longer than that of the control group [（42.3±16.2） d vs（28.7±8.0） d, P〈0.05]. No significant difference was found in the incidence of complications [9 cases（21.4%） vs 13 cases（30.9%）] and the success rate of treatment [37 cases（88.1%） vs 41 cases（97.6%）] between the two groups.Conclusion HIFU ablation is safe and effective for the treatment of CSP with less costs and shorter hospital stay.
出处
《解放军医学院学报》
CAS
2017年第11期1040-1042,1046,共4页
Academic Journal of Chinese PLA Medical School
关键词
瘢痕妊娠
剖宫产
高强度聚焦超声
介入栓塞
scar pregnancy
cesarean section
high intensity focused ultrasound
uterine artery embolization
