摘要
目的:探讨超声引导下双侧子宫动脉栓塞术(UACE)联合清宫术治疗剖宫产切口瘢痕妊娠(CSP)效果及对卵巢功能影响。方法:选取2017年1月-2020年1月本院收治的CSP患者82例,根据治疗方式分组,超声下清宫术治疗41例为对照组,超声引导下双侧UACE联合清宫术41例为观察组。对比两组治疗效果及并发症发生情况,术前及术后3个月检测血清抗苗勒氏管激素(AMH)、促卵泡生成素(FSH)、促黄体生成素(LH)、雌二醇(E2)、泌乳素(PRL)水平。结果:手术成功率对照组(97.6%)与观察组(100.0%)无差异,并发症发生率对照组(7.3%)与观察组(2.4%)无差异(均P>0.05)。观察组术中出血量(76.1±17.2ml)、住院时间(7.0±1.3d)、血绒毛膜促性腺激素复常时间(17.8±3.6d)、包块消退时间(24.9±3.7d)及月经恢复时间(30.2±3.7d)均低于对照组(121.1±33.7ml、9.9±1.9d、27.8±6.1d、33.2±9.3d、38.9±6.7d)(均P<0.05),两组术后月经周期及再妊娠情况无差异(P>0.05)。术后3个月两组血清AMH、FSH、LH、E2、PRL水平均无差异(P>0.05)。结论:超声引导下双侧UACE联合清宫术治疗CSP安全有效,对卵巢功能影响较小,术后恢复更佳。
Objective:To investigate the effect of ultrasound-guided bilateral uterine artery chemoembolization(UACE)combined with uterine evacuation for treating cesarean incision scar pregnancy(CSP)of patients,and to study its influence on the ovarian function of these patients.Methods:82 patients with CSP were selected and were divided into two groups according to the treatment methods from January 2017 to January 2020.41 cases had received UACE treatment were included in control group,and 41 cases had received UACE combined with uterine evacuation were included in observation group.The treatment effect and the complication rate of the patients were compared between the two groups.The levels of serum anti-Müllerian hormone(AMH),follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),and prolactin(PRL)of the patients in the two groups before surgery and in 3 months after surgery were detected.Results:There were no significant differences in the success rate of surgery(97.6%vs.100.0%)and the complication rate(7.3%vs.2.4%)of the patients between the two groups(all P>0.05).The intraoperative blood loss(76.1±17.2ml),the duration of hospital stay(7.0±1.3d),the time of HCG recovery(17.8±3.6d),the time of mass regression(24.9±3.7d),and the time to menstrual recovery(30.2±3.7d)of the patients in the observation group were all significantly lower than those(121.1±33.7ml,9.9±1.9d,27.8±6.1d,33.2±9.3d,and 38.9±6.7d)of the patients in the control group(all P<0.05).There were no significant differences in the postoperative menstrual cycle and re-pregnancy of the patients between the two groups(P>0.05).Three months after operation,there were no significant differences in the levels of serum AMH,FSH,LH,E2,and PRL of the patients between the two groups(P>0.05).Conclusion:Ultrasound-guided bilateral UACE combined with uterine evacuation for treating CSP of the patients is safe and effective,and which has little influence on the ovarian function of the patients,and had better postoperative recovery.
作者
周锋
李晓彦
徐双
ZHOU Feng;LI Xiaoyan;XU Shuang(Nanyang First People's Hospital Affiliated to Henan University,Nanyang,Henan Province,473003)
出处
《中国计划生育学杂志》
2023年第1期135-139,共5页
Chinese Journal of Family Planning
关键词
剖宫产切口瘢痕妊娠
子宫动脉栓塞术
清宫术
腹腔镜
卵巢功能
术后恢复
Cesarean scar pregnancy
Uterine artery chemoembolization
Uterine evacuation
Laparoscopy
Ovarian function
Postoperative recovery
