摘要
目的比较高强度聚焦超声(HIFU)与子宫动脉栓塞(UAE)联合负压吸宫术治疗剖宫产瘢痕妊娠(CSP)的临床疗效及对再次妊娠的影响。方法回顾性分析2017年1月至2019年3月在深圳市妇幼保健院接受HIFU联合吸宫或UAE联合吸宫治疗的134例CSP患者的临床资料,其中HIFU组73例,UAE组61例,随访时间>6个月,有生育要求者随访时间>18个月。比较两组患者的吸宫出血量、住院时间、住院费用、疼痛评分、术后月经情况和再次妊娠率等指标。结果HIFU组患者的住院时间、住院费用、疼痛评分、术后月经量减少发生率分别为3(3,5)d、(11880.19±1376.51)元、2(1,2)分、2.7%,明显低于UAE组的5(4,6)d、(14787.28±2750.36)元、6(6,7)分、29.5%,差异均有统计学意义(P<0.05);HIFU组患者的再次妊娠率为93.3%,明显高于UAE组的48.1%,差异有统计学意义(P<0.05);两组患者的吸宫出血量、吸宫总体有效率、β-HCG下降至正常的时间、月经复潮时间、HCG下降不满意发生率、不全流产发生率和再次CSP发生率比较差异均无统计学意义(P>0.05)。结论HIFU与UAE联合吸宫术均可有效治疗CSP,相对于UAE联合吸宫术,HIFU联合吸宫术治疗CSP在减轻疼痛、减少住院时间和住院费用方面有优势,对术后月经量及再次妊娠影响小,并发症少,适合有再生育需求的CSP患者。
Objective To retrospectively investigate the clinical efficacy of high-intensity focused ultrasound(HIFU)versus uterine artery embolization(UAE)for the treatment of cesarean scar pregnancy(CSP)in combination with negative pressure aspiration and to analyze its effect on re-pregnancy rate.Methods The clinical data of 134 CSP patients who received HIFU or UAE in combination with negative pressure aspiration in Shenzhen Maternity&Child Healthcare Hospital Affiliated to Southern Medical University from January 2017 to March 2019 were analyzed retro-spectively,including 73 patients in HIFU group and 61 patients in UAE group.All the patients were followed up for more than 6 months,and the patients with fertility requirements were followed up for more than 18 months.The amount of uterine bleeding,length of hospital stay,hospitalization expenses,pain score,postoperative menstruation,and pregnan-cy rate were compared between the two groups.Results The hospitalization time,hospitalization expenses,pain score,incidence of reduced menstrual flow after operation in HIFU group were 3(3,5)d,(11880.19±1376.51)yuan,2(1,2),2.7%,respectively,which were significantly lower than corresponding 5(4,6)d,(14787.28±2750.36)yuan,6(6,7),29.5%of UAE group(all P<0.05).The re-pregnancy rate in HIFU group was 93.3%,which was higher than 48.1%of UAE group(P<0.05).There were no statistically significant differences between HIFU group and UAE group in the amount of uterine bleeding,overall effective rate of uterine suction,time ofβ-HCG dropped to normal,time to resume menstruation,incidence of dissatisfaction with HCG decline,incidence of incomplete abortion,and recurrence rate of CSP(all P>0.05).Conclusion HIFU and UAE are both effective treatments for CSP.Compared with UAE,HIFU has the advantages of a lower pain score,shorter length of hospital stay and less hospitalization expenses,and has less effect on the amount of menstruation after operation and re-pregnancy rate,with fewer complications,which is more suitable for patients with fertilit
作者
彭艳
戴宇
余贵媛
杨晓荣
黄梅兰
温萃莉
金平
PENG Yan;DAI Yu;YU Gui-yuan;YANG Xiao-rong;HUANG Mei-lan;WEN Cui-li;JIN Ping(Department of Gynecology,Shenzhen Maternity&Child Healthcare Hospital Affiliated to Southern Medical University,Shenzhen 518017,Guangdong,CHINA)
出处
《海南医学》
CAS
2021年第13期1687-1691,共5页
Hainan Medical Journal
基金
国家先进医疗装备应用示范项目(编号:2018MND10202203)。
关键词
瘢痕妊娠
高强度聚焦超声
子宫动脉栓塞
吸宫术
妊娠
Cesarean scar pregnancy
High-intensity focused ultrasound
Uterine artery embolization
Uterine aspiration
Pregnancy
