[1]朱 萍,于显博,李程程.宫腹腔镜下电吸人流术与子宫动脉栓塞术治疗Ⅱ型瘢痕妊娠临床疗效对比研究[J].陕西医学杂志,2023,52(8):997-1000,1005.[doi:DOI:10.3969/j.issn.1000-7377.2023.08.012]
 ZHU Ping,YU Xianbo,LI Chengcheng.Comparison of therapeutic effects between hysteroscopic electrosuction and artificial abortion and uterine artery embolization in treatment of type Ⅱ scar pregnancy[J].,2023,52(8):997-1000,1005.[doi:DOI:10.3969/j.issn.1000-7377.2023.08.012]
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宫腹腔镜下电吸人流术与子宫动脉栓塞术治疗Ⅱ型瘢痕妊娠临床疗效对比研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年8期
页码:
997-1000,1005
栏目:
临床研究
出版日期:
2023-08-05

文章信息/Info

Title:
Comparison of therapeutic effects between hysteroscopic electrosuction and artificial abortion and uterine artery embolization in treatment of type Ⅱ scar pregnancy
作者:
朱 萍于显博李程程
(沧州市人民医院妇科,河北 沧州061000)
Author(s):
ZHU PingYU XianboLI Chengcheng
(Department of Gynaecology,Cangzhou People's Hospital,Cangzhou 061000,China)
关键词:
Ⅱ型瘢痕妊娠 治疗 宫腹腔镜检查 电吸人流术 子宫动脉栓塞术 血清指标
Keywords:
Type Ⅱ scar pregnancy Therapy Hysteroscopy and laparoscopy Hysteroscopic electrosuction and artificial abortion Uterine artery embolization Serum index
分类号:
R 719.3
DOI:
DOI:10.3969/j.issn.1000-7377.2023.08.012
文献标志码:
A
摘要:
目的:探讨宫腹腔镜下电吸人流术与子宫动脉栓塞术治疗Ⅱ型瘢痕妊娠的临床疗效。方法:选取100例Ⅱ型瘢痕妊娠患者为研究对象,根据治疗方法分为对照组和试验组各50例。对照组行子宫动脉栓塞术治疗,试验组行宫腹腔镜下电吸人流术治疗,比较两组临床疗效、手术指标、血清指标、住院时间、住院费用、术中更改治疗手段发生率、患者对治疗满意度及随访结果。结果:两组临床总有效率比较(96.00%与86.00%),试验组明显高于对照组(P<0.05)。试验组首次月经时间及β-人绒毛膜促性腺激素(β-HCG)恢复正常时间短于对照组,妊娠组织残留率低于对照组(均P<0.05); 两组术中出血量、住院时间、治疗费用两组比较无统计学差异(均P>0.05); 与对照组术后1周比较,试验组术后1周血清微小RNA323-3p(miR-323-3p)、抑制素-A(INH-A)、血管内皮生长因子(VEGF)降低更显著(均P<0.05); 两组术中更改治疗手段总发生率比较无统计学差异(P>0.05)。试验组治疗总满意度为98.00%,显著高于对照组的88.00%(P<0.05); 两组术后1年内再次妊娠率比较无统计学差异(P>0.05); 两组术后1年内均未出现瘢痕妊娠复发情况。结论:宫腹腔镜下电吸人流术可减轻Ⅱ型瘢痕妊娠患者的创伤,有效减少妊娠组织残留率,促进患者康复; 且该手术方式并未增加术中出血量、住院时间及治疗费用,安全性较高,患者治疗满意度高。
Abstract:
Objective:To explore the curative effect of hysteroscopic electroaspiration and uterine artery embolization in the treatment of type Ⅱ scar pregnancy.Methods:A total of 100 patients with type Ⅱ scar pregnancy were selected and divided into control group and experimental group with 50 cases each according to the treatment method.The control group was treated with uterine artery embolization,and the experimental group was treated with hysteroscopic electrosuction and artificial abortion.The curative effect,surgical indexes,serum indexes,hospitalization time,hospitalization cost,incidence of intraoperative treatment change,patients' treatment satisfaction and follow-up results were compared between the two groups.Results:The total clinical effective rate in the experimental group was significantly higher than that in the control group(96.00% vs.86.00%,P<0.05).The first menstruation time and β-HCG was shorter than those of the control group,and the residual rate of pregnancy tissue was lower than that of the control group(all P<0.05).There were no significant differences between the two groups in the amount of intraoperative bleeding,hospital stay and treatment costs(all P>0.05).Compared with the control group one week after operation,the serum levels of miR-323-3p,inhibin-A(INH-A)and VEGF in the experimental group decreased significantly(all P<0.05).There was no significant difference between the two groups in the total incidence of intraoperative treatment changes(P>0.05).The total satisfaction of treatment in the experimental group was 98.00%,significantly higher than 88.00% in the control group(P<0.05).There was no significant difference in the rate of second pregnancy between the two groups within 1 year after operation(P>0.05).There was no recurrence of scar pregnancy in both groups within 1 year after operation.Conclusion:The hysteroscopic electrosuction and artificial abortion can alleviate the trauma of patients with typeⅡ scar pregnancy,effectively reduce the residual rate of pregnancy tissue,and promote the rehabilitation of patients.Moreover,this operation method does not increase the amount of intraoperative bleeding,hospital stay and treatment costs.It has high safety and high patient satisfaction.

参考文献/References:

[1] Timor-Tritsch IE,Horwitz G,Antonio F,et al.Recurrent cesarean scar pregnancy:Case series and literature review[J].Ultrasound Obstet Gynecol,2021,58(1):121-126.
[2] 冯广月,周荣生.活血消癥杀胚方治疗剖宫产切口瘢痕妊娠疗效研究[J].陕西中医,2020,41(12):1727-173.
[3] 谭中宝,毛学群,王庆庆,等.子宫动脉栓塞联合孕囊注射甲氨蝶呤序贯清宫术治疗瘢痕妊娠[J].介入放射学杂志,2020,29(1):96-99.
[4] 殷 倩,孙时清,吴晓凤,等.宫腹腔镜联合手术与腹腔镜手术治疗Ⅲ型剖宫产瘢痕妊娠的效果及围术期应激反应分析[J].中国性科学,2022,31(1):113-116.
[5] 张利媛,李慧东,张 慧,等.剖宫产后瘢痕妊娠早期诊断中经腹部彩色多普勒超声的应用及临床意义分析[J].中国妇幼保健,2020,35(16):3108-3110.
[6] 续云芳,刘晓华,吴庆蓉.两种方法治疗剖宫产后Ⅱ型子宫瘢痕妊娠的疗效比较[J].河北医药,2019,41(24):3770-3772,3776.
[7] Gulino FA,Ettore C,Ettore G.A review on management of caesarean scar pregnancy[J].Curr Opin Obstet Gynecol,2021,33(5):400-404.
[8] 张广霞,张 芳,张孝平,等.中药穴位贴敷联合硬膜外麻醉镇痛对瘢痕子宫再次妊娠经阴分娩产妇妊娠结局影响[J].陕西中医,2019,40(12):1725-1727,1744.
[9] Mohapatra I,Samantray SR.Scar ectopic pregnancy-an emerging challenge[J].Cureus,2021,13(7):16673.
[10] 吴兆军.瘢痕妊娠清宫前子宫动脉栓塞术的应用价值[J].中国妇幼保健,2021,36(4):745-747.
[11] 彭 影,吴 昊,叶桂萍,等.经阴道与宫腹腔镜联合手术治疗Ⅲ型剖宫产瘢痕妊娠的效果[J].安徽医学,2019,40(7):759-761.
[12] 姜大莲,李志红,赵 超,等.辅助生殖技术联合宫腹腔镜治疗输卵管性不孕安全性及疗效观察[J].陕西医学杂志,2018,47(1):71-73.
[13] 李 娜,林耀蕙,申 沛.腹腔镜下子宫瘢痕处妊娠物切除术联合宫腔镜下探查术治疗Ⅱ型或Ⅲ型剖宫产术后子宫瘢痕妊娠的临床效果[J].中国实用医刊,2021,48(14):34-37.
[14] 李洁辉,景 艳,朱卫华,等.宫腔镜联合腹腔镜治疗剖宫产瘢痕妊娠的临床疗效及对患者生活质量的影响[J].医学理论与实践,2020,33(10):1652-1653.
[15] 刘利兰.血清miR-873和miR-323-3p水平在异位妊娠诊断中的应用价值分析[J].中国医师杂志,2020,22(5):745-748.
[16] 邹 颖.高强度聚焦超声联合氨甲蝶呤肌内注射对瘢痕妊娠患者卵巢储备功能、血流指数、INH-A、VEGF的影响[J].检验医学与临床,2022,19(3):367-370,374.
[17] 冯 亮,樊 力.骨髓间充质干细胞通过增加血管生成和血管内皮生长因子表达影响大鼠随意型皮瓣存活实验研究[J].陕西医学杂志,2022,51(3):298-302.
[18] 李 凡,王如萍,周 萍.不同治疗方案对异位妊娠患者血清β-hCG、P及VEGF的影响及安全性[J].河北医学,2020,26(7):1092-1097.
[19] 董君肖,韩玉英,王庆一.腹腔镜联合宫腔镜手术治疗子宫瘢痕妊娠的临床效果[J].中国当代医药,2020,27(36):109-112.
[20] 张珊珊,王美芬,柴泽英,等.宫腹腔镜联合治疗Ⅲ型或包块型剖宫产瘢痕部位妊娠5例分析[J].中华全科医师杂志,2019,18(3):264-266.

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备注/Memo

备注/Memo:
基金项目:河北省医学科学研究计划项目(20232087); 河北省沧州市科技项目(162302132)
更新日期/Last Update: 2023-08-07