86例剖宫产术后子宫瘢痕处妊娠临床诊疗分析

发布时间：2018-11-08 07:12

【摘要】：目的 :探讨剖宫产术后子宫瘢痕处妊娠的临床特点及发病原因,评价其不同治疗方式的疗效。方法 :回顾性分析86例剖宫产术后子宫瘢痕处妊娠患者的临床资料,根据患者治疗方法不同分为MTX药物治疗组(13例)、子宫动脉栓塞联合清宫术组(45例)和手术治疗组(28例),从治疗后血β-h CG下降百分比、血β-h CG下降至正常时间、瘢痕部位病灶消失时间、月经恢复来潮时间及住院时间和住院费用等方面进行评价。结果:药物治疗组成功率53.85%,子宫动脉栓塞联合清宫术组成功率93.33%,手术治疗组成功率100.00%。3组在治疗后血β-h CG恢复至正常时间及治疗后瘢痕部位病灶消失时间差异有统计学意义(P0.05),而在住院费用上无明显差异(P0.05);子宫动脉栓塞联合清宫术组和手术治疗组在治疗后血β-h CG下降百分比及住院时间上无明显差异(P0.05),但两者优于MTX药物治疗组;在月经恢复来潮时间上手术组明显优于MTX药物治疗组和子宫动脉栓塞联合清宫术组(P0.05)。结论:子宫动脉栓塞联合清宫术及瘢痕妊娠病灶切除加修补术治疗剖宫产术后子宫瘢痕处妊娠成功率较高,可在有条件的医院开展。
[Abstract]:Objective: to investigate the clinical characteristics and causes of pregnancy in uterine scar after cesarean section, and to evaluate the curative effect of different treatment methods. Methods: the clinical data of 86 cases of pregnancy in uterine scar after cesarean section were analyzed retrospectively. According to the different treatment methods, the patients were divided into MTX drug treatment group (13 cases). Uterine artery embolization combined with uterine curettage group (45 cases) and surgical treatment group (28 cases), blood 尾 -h CG decreased, blood 尾 -h CG decreased to normal time, scar lesion disappeared time after treatment. Menstrual recovery time, hospitalization time and hospital expenses were evaluated. Results: the success rate of drug treatment group was 53.85 and that of uterine artery embolization combined with uterine clearance group was 93.33. The success rate of operation group 100.00.3 had significant difference in the recovery time of serum 尾 -h CG to normal after treatment and the time of lesion disappearance in scar after treatment (P0.05), but there was no significant difference in hospital expenses (P0.05). There was no significant difference in the percentage of serum 尾 -h CG and the length of hospitalization between the uterine artery embolization group and the operation group (P0.05), but the two groups were better than the MTX drug treatment group. The time of menarche recovery in operation group was significantly better than that in MTX group and uterine artery embolization combined with uterine clearance group (P0.05). Conclusion: uterine artery embolization combined with uterine curettage and scar pregnancy focus resection and repair has a higher success rate of pregnancy in uterine scar after cesarean section, which can be carried out in a qualified hospital.
【作者单位】：南京医科大学第一附属医院妇科;
【基金】：国家自然科学基金(81472442;81272871) 江苏省医学重点人才项目[苏卫科教(2011)15号]
【分类号】：R714.22

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