摘要
目的探讨腹腔镜下切开取胚术联合子宫动脉栓塞术治疗外生型剖宫产瘢痕妊娠的效果及对患者卵巢功能、再次妊娠的影响。方法选取2017年1月至2020年1月我院收治的70例外生型剖宫产瘢痕妊娠患者,以数字表法随机将其分为对照组和观察组,各35例。对照组采用腹腔镜下切开取胚术治疗,观察组在对照组基础上联合子宫动脉栓塞术治疗。比较两组的手术效果。结果观察组取胚手术时间短于对照组,术中出血量少于对照组,中转开腹率低于对照组(P<0.05);两组患者的月经恢复时间无显著差异(P>0.05)。术前及术后1个月,两组患者的FSH、E2、LH、INHB及AMH水平无明显差异(P>0.05);术后1个月,两组的FSH水平均较术前升高,E2、LH、INHB及AMH水平均较术前降低(P<0.05)。术前及术后1个月,两组患者的SCC-Ag、sFlt-1及Ki-67水平无明显差异(P>0.05);术后1个月,两组的SCC-Ag、sFlt-1及Ki-67水平均较术前降低(P<0.05)。两组术后2、7、14 d的血β-HCG下降率及术后1年的再次妊娠率均无明显差异(P>0.05)。结论腹腔镜下切开取胚术联合子宫动脉栓塞术治疗外生型剖宫产瘢痕妊娠有助于缩短手术时间,减少术中出血量,降低中转开腹手术率,且不会对患者卵巢功能、生育功能及预后情况造成明显影响,值得推广。
Objective To explore the effect of laparoscopic incision and embryo extraction combined with uterine artery embolization in the treatment of exogenous cesarean section scar pregnancy and its influences on ovarian function and second pregnancy of patients.Methods A total of 70 patients with exogenous cesarean section scar pregnancy treated in our hospital from January 2017 to January 2020 were selected and randomly divided into control group and observation group by digital table method,with 35 cases in each group.The control group was treated with laparoscopic incision and embryo extraction,and the observation group was treated with uterine artery embolization on the basis of the control group.The surgical effects of the two groups were compared.Results The operation time of embryo extraction in the observation group was shorter than that in the control group,the blood loss volume during the operation was less than that in the control group,and the conversion rate to laparotomy was lower than that in the control group(P<0.05);there was no significant difference in recovery time of menstruation between the two groups(P>0.05).Before and 1 month after operation,there were no significant differences in the levels of FSH,E2,LH,INHB and AMH between the two groups(P>0.05);one month after operation,the level of FSH in the two groups was higher than that before operation,and the levels of E2,LH,INHB and AMH were lower than those before operation(P<0.05).Before and 1 month after operation,there were no significant differences in SCC-Ag and sFlt-1 Ki-67 levels between the two groups(P>0.05);one month after operation,the levels of SCC-Ag,sFlt-1 and Ki-67 in the two groups were lower than those before operation(P<0.05).There were no significant differences inβ-HCG reduction rate at 2,7,14 d after operation and the second pregnancy rate at 1 year after operation between the two groups(P>0.05).Conclusion Laparoscopic incision and embryo extraction combined with uterine artery embolization in the treatment of exogenous cesarean
作者
崔莉娜
赵丽宏
李爱明
CUI Li'na;ZHAO Lihong;LI Aiming(the People's Hospital of Heyang County,Weinan 715300;Yan'an People's Hospital,Yan'an 716000,China)
出处
《临床医学研究与实践》
2022年第2期116-119,共4页
Clinical Research and Practice
基金
陕西省卫生科研基金(No.2016LC099)。
关键词
腹腔镜下切开取胚术
子宫动脉栓塞术
外生型剖宫产瘢痕妊娠
卵巢功能
再次妊娠
laparoscopic incision and embryo extraction
uterine artery embolization
exogenous cesarean section scar pregnancy
ovarian function
second pregnancy
