134例剖宫产瘢痕妊娠不同治疗方法的疗效观察。

IF 1.3 Q3 Medicine

Minerva chirurgica Pub Date : 2020-07-16 DOI:10.23736/S0026-4733.20.08412-6

Wenjian Zhang, Yan Liu, Yaling Jiang, Xinhua Yuan, X. Sheng

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Group A was sub-grouped according to the pretreatments: ultrasound guided uterine evacuation (A1), uterine arterial embolism (UAE) + ultrasound guided uterine evacuation (A2), high-intensity focused ultrasound (HIFU) + ultrasound guided uterine evacuation (A3); Group B was sub-groups according to pretreatments: laparotomy (B1), UAE + laparotomy (B2) .\n\n\nRESULTS\nThe success rates of treatment in groups A and B were 72.73%、100%, and it was statistically significant (P <0.05) There were no statistically significant in the blood loss and the degree of decrease of β - hCG in these two group (P > 0.05). The operation time, length of stay and cost were statistically significant between curettage group and laparotomy group (P < 0.05); there was no significant difference in the degree of β-HCG decrease (%) and surgical bleeding volume. The success rate in group A1-A3 was 64.10%, 96.52% and 100% respectively, which was statistically significant (P < 0.05). 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引用次数: 0

摘要

方法对广州医科大学附属第三医院134例剖宫产瘢痕妊娠患者的临床资料进行回顾性分析。按治疗方案分组：治疗前+超声引导下刮除术组（A组），治疗前+剖腹探查术组（B组）。A组按预处理方式分组：超声引导下子宫排空（A1）、子宫动脉栓塞（UAE）+超声引导下宫腔排空（A2）、高强度聚焦超声（HIFU）+超声指导下宫腔抽空（A3）；结果A、B两组治疗成功率分别为72.73%、100%，有统计学意义（P＜0.05），刮宫组与剖腹组在手术时间、住院时间、费用等方面有统计学意义；β-HCG下降程度（%）与手术出血量无显著性差异。A1-A3组成功率分别为64.10%、96.52%和100%，具有统计学意义（P<0.05），手术时间无统计学意义，A1-A3组术后5天内住院时间和β-hCG下降程度（P>0.05）。A1组和A3组的失血量和费用有统计学意义（P<0.05）。B1-B2组的成功率均为100%，无统计学意义（P>0.05），结论超声引导下子宫刮除术可作为I型和II型瘢痕妊娠的较好治疗方法。刮术前的UAE或HIFU可以减少子宫出血，而剖腹术前的阿联酋不能减少子宫出血。

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Efficacy of different treatment of 134 cases of cesarean scar pregnancy.

BACKGROUND To compare the clinical efficacy of different methods for treating cesarean scar pregnancy (CSP). METHODS The clinical data of 134 patients diagnosed with CSP in the Third Affiliated Hospital of Guangzhou Medical University were retrospectively analyzed. Grouped by treatment plan: pretreatments +ultrasound guided Curettage group (group A), pretreatments+ laparotomy (group B). Group A was sub-grouped according to the pretreatments: ultrasound guided uterine evacuation (A1), uterine arterial embolism (UAE) + ultrasound guided uterine evacuation (A2), high-intensity focused ultrasound (HIFU) + ultrasound guided uterine evacuation (A3); Group B was sub-groups according to pretreatments: laparotomy (B1), UAE + laparotomy (B2) . RESULTS The success rates of treatment in groups A and B were 72.73%、100%, and it was statistically significant (P <0.05) There were no statistically significant in the blood loss and the degree of decrease of β - hCG in these two group (P > 0.05). The operation time, length of stay and cost were statistically significant between curettage group and laparotomy group (P < 0.05); there was no significant difference in the degree of β-HCG decrease (%) and surgical bleeding volume. The success rate in group A1-A3 was 64.10%, 96.52% and 100% respectively, which was statistically significant (P < 0.05). No statistically significant were showed in operation time, Length of stay and the degree of decrease of β - hCG within 5 days after operation in A1-A3 group (P > 0.05). The blood loss and cost between A1 and A3 groups were statistically significant (P < 0.05). The success rate in group B1-B2 were both 100%, with no statistically significant (P> 0.05). There were no statistically significant in operation time, blood loss, degree of decrease of β- hCG, length of stay between the two groups (P > 0.05). The cost between the two groups was statistically significant (P < 0.05). CONCLUSIONS Ultrasound-guided uterine Curettage can be used as a better treatment for type I and II scar pregnancy. UAE or HIFU before Curettage can reduce uterine bleeding, while UAE before the laparotomy did not reduce uterine bleeding.

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来源期刊

Minerva chirurgica 医学-外科

CiteScore

1.40

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Minerva Chirurgica publishes scientific papers on surgery. Manuscripts may be submitted in the form of editorials, original articles, review articles, case reports, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work.