摘要
目的探讨术前中西医结合药物预处理在剖宫产术后子宫瘢痕妊娠(CSP)患者宫腔镜下妊娠病灶清除术中的应用价值,为临床治疗提供指导建议。方法回顾性分析72例接受宫腔镜下妊娠病灶清除术治疗的CSP患者的临床资料,随机分为A组(34例)、B组(38例)。B组患者实施子宫动脉化疗栓塞术(UACE)治疗后行宫腔镜下妊娠病灶清除术,术前无药物预处理;A组患者在UACE治疗基础上实施中西医结合药物预处理后行宫腔镜下妊娠病灶清除术。比较两组围术期相关指标[手术时间、术中出血量、输血量、住院天数、治疗费用、术后血清人绒毛膜促性腺激素(β-hCG)、术后血红蛋白(Hb)、甲氨蝶呤应用剂量]。结果A组的手术时间(22.0±10.8)min短于B组的(79.2±22.0)min、治疗费用(10476.5±2003.2)元低于B组的(12960.5±2888.7)元,差异有统计学意义(P<0.05);两组术后血清β-hCG、术后Hb、术中出血量、输血量、甲氨蝶呤应用剂量、住院天数比较,差异均无统计学意义(P>0.05)。两组患者在治疗过程中均未切除子宫,术后均无残留。结论CSP患者应用中西医结合药物进行预处理后再行宫腔镜下妊娠病灶清除术,手术效果显著,且具有手术时间短、治疗费用低的优势。
Objective To explore the application value of integrated Chinese and Western medicine pretreatment in hysteroscopic debridement surgery of cesarean scar pregnancy(CSP)patients,so as to provide guidance and suggestions for clinical treatment.Methods The clinical data of 72 CSP patients who underwent hysteroscopic debridement surgery were retrospectively analyzed,and they were randomly divided into group A(34 cases)and group B(38 cases).In group B,hysteroscopic debridement surgery was performed after uterine arterial chemoembolization(UACE)treatment without drug pretreatment before surgery;in group A,on the basis of UACE treatment,integrated Chinese medicine and Western medicine pretreatment was performed before hysteroscopic debridement surgery.Both groups were compared in terms of perioperative related indexes[operation time,intraoperative blood loss,blood transfusion,length of hospital day,treatment cost,and postoperative serum beta human chorionic gonadotropin(β-hCG),postoperative hemoglobin(Hb),and methotrexate application dose].Results Group A had shorter operation time of(22.0±10.8)min than(79.2±22.0)min in group B,and lower treatment cost of(10476.5±2003.2)yuan than(12960.5±2888.7)yuan in group B,and the difference was statistically significant(P<0.05).Comparison of postoperative serumβ-hCG,postoperative Hb,intraoperative blood loss,blood transfusion,methotrexate application dose,and length of hospital stay between the two groups showed no statistically significant difference(P>0.05).Both groups did not remove the uterus during treatment,and none of them had residuals after surgery.Conclusion Hysteroscopic debridement surgery after pretreatment with integrated Chinese and Western medicine shows significant surgical effect on CSP patients,and has the advantages of short operation time and low treatment cost.
作者
任宝红
赵蓉
REN Bao-hong;ZHAO Rong(Wuxi Hospital of Traditional Chinese Medicine,Wuxi 214000,China)
出处
《中国实用医药》
2024年第14期151-153,共3页
China Practical Medicine
关键词
中西医结合
药物预处理
宫腔镜下妊娠病灶清除术
剖宫产术后子宫瘢痕妊娠
子宫动脉栓塞
Integrated Chinese and Western medicine
Drug pretreatment
Hysteroscopic debridement surgery
Cesarean scar pregnancy
Uterine artery embolization
