| 钱亮,李鼎恒.超声引导下聚桂醇注射联合清宫术治疗疤痕妊娠的临床疗效及影响因素观察[J].浙江中西医结合杂志,2020,30(8): |
| 超声引导下聚桂醇注射联合清宫术治疗疤痕妊娠的临床疗效及影响因素观察 |
| Effect of lauromacrogol combined with curettage on uterine scar pregnancy after cesarean section |
| 投稿时间：2019-08-15 修订日期：2020-01-12 |
| DOI： |
| 中文关键词: 子宫疤痕妊娠，聚桂醇，清宫术 |
| 英文关键词:uterine scar pregnancy lauromacrogol aspiration |
| 基金项目:杭州市社会发展科研自主申报项目,研究编号20170533B59 |
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| 中文摘要: |
| 探讨超声引导下聚桂醇注射联合清宫术治疗疤痕妊娠的临床疗效及影响因素。方法 回顾性分析2015年12月至2018年12月我院131例子宫疤痕妊娠患者的临床资料，将61例在超声引导下聚桂醇注射联合清宫术的患者分为观察组，另外70例行子宫动脉栓塞术联合清宫术的患者分为对照组，比较两组临床治疗效果。同时根据孕囊附着疤痕处的血供情况，探讨影响该方法临床疗效的因素。结果 观察组与对照组在治疗有效率、术中出血量以及术后β-HCG恢复时间方面相比差异无统计学意义（P>0.05），但两组在住院时间、手术时间及治疗费用方面相比差异有统计学意义（P<0.05）。另外观察组中，根据孕囊附着疤痕处的血供丰富程度分为较高与较低组，两组在孕囊大小，疤痕厚度，妊娠天数之间比较差异无统计学意义(P>0.05)，但在术前β-HCG值，聚桂醇使用量以及术中出血量的比较差异有统计学意义（P<0.05）。结论 超声引导下聚桂醇注射联合清宫术疗效明确，术后恢复快，费用少，值得临床推广，但应术前充分评估孕囊附着疤痕处的血供情况，提高手术成功率及减少术中出血量。 |
| 英文摘要: |
| Objective To evaluate the efficacy and influence factor of the ultrasound-guided local lauromacrogol injection combined with aspiration for cesarean scar pregnancy. Methods Retrospective analysis was carried out on the clinical data of 70 patients undergoing aspiration in 48-72 hours after uterine artery embolization in control group and 61patients undergoing aspiration in 3-24 hours after transvaginal ultrasoundguided percutaneous injection of lauromacrogol in observation group, and the clinical therapeutic effects of two groups were compared. At the same time, according to the signal strength of blood flow at the scar and gestational sac, the factors influencing the efficacy of this treatment were discussed. Result There were no statistically significant differences between the observation group and the control group in terms of treatment success rate, the amount of aspiration bleeding, the time of lesion absorption and human chorionicSgonadotropin(β-HCG) recovery time (P >0.05), but there were statistically significant differences between the two groups in terms of hospitalization time, operation time and the cost of treatment (P<0.05). In addition, for the observation group, the amount of bleeding in the aspiration and the amount of lauromacrogol injection were less in patients with less abundant blood flow signals around the pregnant sac. Conclusion The efficacy of the ultrasound-guided local lauromacrogol injection combined with aspiration for cesarean scar pregnancy is safety and feasible, which is worthy of clinical promotion. However, the blood flow richness around the scar should be fully evaluated before operation, so as to improve the success rate of operation and reduce the amount of intraoperative blood loss. |
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