直接B超引导下吸刮术治疗内生型疤痕妊娠疗效观察

发布时间：2018-06-03 20:51

本文选题：剖宫产后疤痕妊娠 + 吸刮术　；参考：《山东医药》2017年09期

【摘要】：目的探讨直接B超引导下吸刮术治疗内生型剖宫产后疤痕妊娠(CSP)的疗效及安全性。方法选取70例CSP患者,均停经小于14周,孕囊直径1~5 cm,孕囊与膀胱壁间肌层厚度2 mm以上。根据治疗方法不同将其分为观察组18例与对照组52例,观察组直接于B超引导下行吸刮术,对照组予双侧子宫动脉化疗栓塞后行B超引导下吸刮术,比较两组治疗效果,包括刮宫耗时、术中出血量、术后血红蛋白值及β-HCG值、住院时间、住院费用。结果观察组与对照组刮宫耗时分别为(12.72±3.54)、(21.71±16.32)min,住院时间分别为(5.78±2.92)、(8.96±3.90)d,住院费用分别为(3 182.76±430.14)、(18 039.95±526.67)元,两组刮宫耗时、住院时间、住院费用比较,P均0.05。观察组与对照组在术中出血量、术后血红蛋白值、β-HCG值、β-HCG值降至正常及月经恢复时间上差异无统计学意义(P均0.05)。结论对于停经不足14周,孕囊直径1~5 cm,孕囊与膀胱壁间肌层厚度2 mm以上,出血量不多的内生型CSP患者可直接于B超引导下行吸刮术,可避免子宫动脉栓塞化疗导致的不良反应及弊端,并可缩短住院时间、减少治疗费用。
[Abstract]:Objective to evaluate the efficacy and safety of direct B-ultrasound guided aspiration and curettage in the treatment of cesarean scar pregnancy (CSP) after cesarean section. Methods 70 patients with CSP were selected. All of them were postmenopausal for less than 14 weeks, gestational sac was 1 ~ 5 cm in diameter, and the thickness of the muscular layer between the bladder wall and the gestational sac was more than 2 mm. According to the different treatment methods, it was divided into the observation group (n = 18) and the control group (n = 52). The observation group was treated directly with B-ultrasound guided curettage, and the control group was treated with B-ultrasound guided curettage after bilateral uterine artery chemoembolization. These include time consuming, intraoperative bleeding, postoperative hemoglobin and 尾 -HCG, length of stay, and hospital expenses. Results the time of curettage in the observation group and the control group was 21.71 卤16.32 min, and the hospitalization time was 5.78 卤2.92 卤3.90 min, respectively, and the hospitalization cost was 3 182.76 卤430.14 (18 039.95 卤526.67) yuan, respectively. There was no significant difference in blood loss, hemoglobin value, 尾 -HCG value and menstrual recovery time between the observation group and the control group (P < 0.05). Conclusion Endogenous CSP patients with less than 14 weeks of menopause, gestational sac diameter of 1 ~ 5 cm, thickness of more than 2 mm between the pregnant sac and the bladder wall, and less bleeding can be directly guided by B-ultrasound guided aspiration and curettage. It can avoid the adverse reaction and malpractice caused by uterine artery chemoembolization, shorten the hospitalization time and reduce the cost of treatment.
【作者单位】：安徽医科大学第一附属医院;
【分类号】：R714.22

【参考文献】