子宫动脉栓塞联合宫腔镜治疗子宫切口妊娠的疗效分析(1)
摘 要：目的 分析子宫动脉栓塞联合宫腔镜治疗子宫切口妊娠的临床疗效。方法 选取50例汉川市第二人民医院2015年9月～2017年5月收治的子宫切口妊娠患者，通过随机方式将其分为常规组和联合组，各25例，给予常规组患者肌注氨甲蝶呤及B超检测下清宫术治疗，给予联合组患者子宫动脉栓塞联合宫腔镜下清宫术治疗，观察两组患者术中各指标水平，不良反应发生情况。结果 联合组患者各手术指标术中出血、阴道流血时间、血β-HCG转阴时间水平均低于常规组患者，差异有统计学意义(P<0.05)；联合组患者不良反应发生率低于常规组患者，差异有统计学意义(P<0.05)。结论 子宫动脉栓塞联合宫腔镜治疗子宫切口妊娠的临床疗效显著，能有效降低術中出血量，加快患者术后恢复，且具有较高的安全性，临床价值较高。
关键词：子宫动脉栓塞；宫腔镜；子宫切口妊娠
中图分类号：R714.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.07.035
, 百拇医药
文章编号：1006-1959(2018)07-0108-02
Clinical Analysis of Uterine Artery Embolization Combined with Hysteroscopy in the Treatment of Uterine Incision Pregnancy
CHEN Jin-jun
(Department of Obstetrics and Gynecology，Second People's Hospital，Hanchuan 431602，Hubei，China)
Abstract：Objective To analyze the clinical effect of uterine artery embolization combined with hysteroscopy in the treatment of uterine incision pregnancy.Methods 50 cases of uterine incision pregnancy treated in the Second People's Hospital of Hanchuan city from September 2015 to May 2017 were randomly divided into routine group and combined group with 25 cases each.The patients in the routine group were treated with intramuscular injection of methotrexate and B ultrasound for curettage.The patients in the combined group were treated by uterine artery embolization combined with hysteroscopic curettage.The levels of each index and the incidence of adverse reactions in the two groups were observed.Results A group of patients with the index of operation， intraoperative bleeding， vaginal bleeding time and blood β-HCG negative time level were lower than the normal group，the difference was statistically significant(P<0.05)；combined group the incidence of adverse reactions is lower than that of the routine group，the difference was statistically significant(P<0.05).Conclusion Uterine artery embolization combined with hysteroscopy in the treatment of uterine incision pregnancy has significant clinical effect.It can effectively reduce intraoperative blood loss and speed up postoperative recovery，and has high safety and high clinical value.
, 百拇医药
Key words：Uterine artery embolization；Hysteroscopy；Uterine incision pregnancy
剖宫产术后切口妊娠是一种较为罕见且极难以处理的异位妊娠情况，是指妊娠囊在前次剖宫产子宫瘢痕处着床，是一种剖宫产远期并发症。这种异位妊娠在早期难以诊断，而没有及时诊断且停止妊娠极易造成患者子宫破裂并发大出血，对患者的生命健康产生极大的危害[1]。随着剖宫产率的上升，该病发生率也在上升，因此早期诊断并予以及时治疗对保障患者生育能力和身体健康、安全具有重要的意义。本次研究选取2015年9月～2017年5月汉川市第二人民医院收治的剖宫产术后切口妊娠患者50例，对其中25例患者施加了子宫动脉栓塞联合宫腔镜下清宫术治疗，探讨其治疗效果，具体如下。
1资料与方法
1.1一般资料 选取2015年9月～2017年5月汉川市第二人民医院收治的剖宫产术后切口妊娠患者50例进行研究，本次研究经过医院伦理委员会批准。所有产妇均为经产妇，受孕次数2～7次，分娩次数1～3次，且前次分娩都为剖宫产，且选择子宫下端横位切口，所有患者排除严重脏器疾病，且均符合剖宫产术后切口妊娠的诊断标准，血β-HCG≥5000 IU/L。通过随机方式将患者分为常规组和联合组各25例。常规组患者年龄22～38岁，平均年龄(28.31±5.12)岁，停经时间39～88 d，平均停经时间(49.31±6.12)d；联合组患者年龄22～37岁，平均年龄(28.11±4.92)岁，停经时间38～87 d，平均停经时间(48.44±6.22)d；两组患者一般资料差异，无统计学意义(P>0.05)，具有可比性。, 百拇医药(陈进军)
关键词：子宫动脉栓塞；宫腔镜；子宫切口妊娠
中图分类号：R714.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.07.035
, 百拇医药
文章编号：1006-1959(2018)07-0108-02
Clinical Analysis of Uterine Artery Embolization Combined with Hysteroscopy in the Treatment of Uterine Incision Pregnancy
CHEN Jin-jun
(Department of Obstetrics and Gynecology，Second People's Hospital，Hanchuan 431602，Hubei，China)
Abstract：Objective To analyze the clinical effect of uterine artery embolization combined with hysteroscopy in the treatment of uterine incision pregnancy.Methods 50 cases of uterine incision pregnancy treated in the Second People's Hospital of Hanchuan city from September 2015 to May 2017 were randomly divided into routine group and combined group with 25 cases each.The patients in the routine group were treated with intramuscular injection of methotrexate and B ultrasound for curettage.The patients in the combined group were treated by uterine artery embolization combined with hysteroscopic curettage.The levels of each index and the incidence of adverse reactions in the two groups were observed.Results A group of patients with the index of operation， intraoperative bleeding， vaginal bleeding time and blood β-HCG negative time level were lower than the normal group，the difference was statistically significant(P<0.05)；combined group the incidence of adverse reactions is lower than that of the routine group，the difference was statistically significant(P<0.05).Conclusion Uterine artery embolization combined with hysteroscopy in the treatment of uterine incision pregnancy has significant clinical effect.It can effectively reduce intraoperative blood loss and speed up postoperative recovery，and has high safety and high clinical value.
, 百拇医药
Key words：Uterine artery embolization；Hysteroscopy；Uterine incision pregnancy
剖宫产术后切口妊娠是一种较为罕见且极难以处理的异位妊娠情况，是指妊娠囊在前次剖宫产子宫瘢痕处着床，是一种剖宫产远期并发症。这种异位妊娠在早期难以诊断，而没有及时诊断且停止妊娠极易造成患者子宫破裂并发大出血，对患者的生命健康产生极大的危害[1]。随着剖宫产率的上升，该病发生率也在上升，因此早期诊断并予以及时治疗对保障患者生育能力和身体健康、安全具有重要的意义。本次研究选取2015年9月～2017年5月汉川市第二人民医院收治的剖宫产术后切口妊娠患者50例，对其中25例患者施加了子宫动脉栓塞联合宫腔镜下清宫术治疗，探讨其治疗效果，具体如下。
1资料与方法
1.1一般资料 选取2015年9月～2017年5月汉川市第二人民医院收治的剖宫产术后切口妊娠患者50例进行研究，本次研究经过医院伦理委员会批准。所有产妇均为经产妇，受孕次数2～7次，分娩次数1～3次，且前次分娩都为剖宫产，且选择子宫下端横位切口，所有患者排除严重脏器疾病，且均符合剖宫产术后切口妊娠的诊断标准，血β-HCG≥5000 IU/L。通过随机方式将患者分为常规组和联合组各25例。常规组患者年龄22～38岁，平均年龄(28.31±5.12)岁，停经时间39～88 d，平均停经时间(49.31±6.12)d；联合组患者年龄22～37岁，平均年龄(28.11±4.92)岁，停经时间38～87 d，平均停经时间(48.44±6.22)d；两组患者一般资料差异，无统计学意义(P>0.05)，具有可比性。, 百拇医药(陈进军)