摘要
目的:观察超声下孕囊内注药在子宫瘢痕妊娠中的应用效果。方法:选择2019年2月至2020年4月河北省邯郸市中心医院收治的剖宫产术后瘢痕妊娠实施早期终止妊娠患者80例。按随机数字表法分为观察组和对照组,每组40例。观察组实施超声引导下孕囊内注药,对照组行数字减影血管造影术(DSA)引导下双侧子宫动脉栓塞,术后随访1个月,比较两组治疗前后子宫前壁下段肌层厚度和阻力指数、抗苗勒管激素(AMH)水平;比较术中出血、术后住院时间、术后月经复潮时间、术后并发症情况及术后1周血人绒毛膜促性腺激素(Hcg)水平和血Hcg转阴时间。结果:治疗后两组子宫前壁下段肌层厚度均小于治疗前(P<0.05),观察组子宫前壁下段肌层厚度大于对照组(P<0.05),治疗后两组AMH水平均显著高于治疗前,且治疗后观察组AMH水平高于对照组(P<0.05),观察组术中出血少于对照组(P<0.05),术后住院时间短于对照组(P<0.05),术后月经复潮时间早于对照组(P<0.05),观察组发生术后出血、术后严重疼痛、术后感染及妊娠物残留的总比例显著低于对照组(P<0.05),术后1周观察组血Hcg水平低于对照组(P<0.05),血Hcg转阴时间短于对照组(P<0.05)。结论:子宫瘢痕妊娠行超声下孕囊内注药并结合宫腔镜手术治疗,能有效的促进患者术后子宫肌层组织的再生,减少对内分泌功能影响,且手术并发症少,效果明确。
Objective: To explore the clinical application effect of intracapsular injection of drugs under ultrasound in uterine scar pregnancy. Methods:A total of 80 patients with scar pregnancy after cesarean section in Handan Central Hospital from February 2019 to April 2020 were selected, and randomly divided into an observation group and a control group, with 40 cases in each group. The patients in the observation group were injected with drugs in pregnancy sac under the guidance of ultrasound, and those in the control group were treated with bilateral uterine artery embolization under the guidance of Digital Subtraction Angiography(DSA). After one month follow-up, the thickness and resistance index of myometrium in the lower anterior wall of uterus and the level of anti-Mullerian hormone(AMH) were compared.The intraoperative bleeding volume, hospital days, menstrual resurgence time, complications, blood Hcglevel and the negative time of blood Hcgafter one week of operationwere compared as well. Results: After treatment, the thickness of myometrium in lower anterior wall of uterus in both groups wasdecreased, and it was higher in the observation group(P<0.05). After treatment, the AMH level in both groups was significantly elevated, and it was higher in the observation group than that in the control group(P<0.05). The intraoperative bleeding volume was less in the observation group compared with the control group. The blood Hcg level was lower, and the hospital days, menstrual resurgence time and the negative conversion time of blood Hcg were shorter in theobservation group compared with the control group(P<0.05). The total rate of postoperative bleeding, postoperative severe pain, postoperative infection and pregnancy residue were significantly lower in the observation group compared with the control group(P<0.05). Conclusion:Ultrasound injection of drugs into the pregnancy sac combined with hysteroscopic surgery for scar pregnancy can effectively promote the regeneration of myometrium tissue after surgery, reduce the
作者
赵红
田芬
张力
吕君楠
邢凯
申志华
尹素芳
周虎
Zhao Hong;Tian Fen;Zhang Li;Lyu Junnan;Xing Kai;Shen Zhihua;Yin Sufang;Zhou Hu(Handan Cen-tral Hospital of Hebei Province,Handan 056001,China;General Hospital of Handan Mining Group Co.,Ltd.,Handan 056001,China)
出处
《广西医科大学学报》
CAS
2021年第6期1187-1191,共5页
Journal of Guangxi Medical University
基金
河北省2020年度医学科学研究课题计划项目(No.20200450)。
关键词
超声引导
孕囊内注药
子宫瘢痕妊娠
ultrasound guidance
intrathecal injection of drugs during pregnancy
scar pregnancy of uterus
