CAJ | 학술논문

目的：观察血管介入治疗剖宫产术后子宫瘢痕妊娠的临床疗效。方法：选择50例剖宫产术后子宫瘢痕妊娠患者，随机分为观察组和对照组，每组25例。对照组患者给予刮宫术治疗，观察组患者给予子宫动脉栓塞术联合甲氨蝶呤清宫术治疗。治疗结束后比较两组患者的临床疗效、术中出血量、血清β‐人绒毛膜促性腺激素（β‐HCG ）恢复正常时间、子宫内包块消失时间、患者的住院时间以及不良反应。结果：观察组患者的治愈率（100％）明显高于对照组患者（64％），P＜0．05；观察组患者的术中出血量（47．1±14．2）m L、子宫内包块消失时间（23．6±23．7）d以及住院时间（13．2±4．3）d均明显分别少于或短于对照组患者[（322．1±105．2）mL、（80．4±78．3）d、（20．1±7．8）d]，P＜0．05；两组患者均未发生严重并发症。结论：采用血管介入治疗剖宫产术后子宫瘢痕妊娠，能有效杀灭胚胎组织、减少出血，且能保留子宫、保存生育功能。
목적：관찰혈관개입치료부궁산술후자궁반흔임신적림상료효。방법：선택50례부궁산술후자궁반흔임신환자，수궤분위관찰조화대조조，매조25례。대조조환자급여괄궁술치료，관찰조환자급여자궁동맥전새술연합갑안접령청궁술치료。치료결속후비교량조환자적림상료효、술중출혈량、혈청β‐인융모막촉성선격소（β‐HCG ）회복정상시간、자궁내포괴소실시간、환자적주원시간이급불량반응。결과：관찰조환자적치유솔（100％）명현고우대조조환자（64％），P＜0．05；관찰조환자적술중출혈량（47．1±14．2）m L、자궁내포괴소실시간（23．6±23．7）d이급주원시간（13．2±4．3）d균명현분별소우혹단우대조조환자[（322．1±105．2）mL、（80．4±78．3）d、（20．1±7．8）d]，P＜0．05；량조환자균미발생엄중병발증。결론：채용혈관개입치료부궁산술후자궁반흔임신，능유효살멸배태조직、감소출혈，차능보류자궁、보존생육공능。
Objective:To observe the clinical efficacy of vascular intervention in the treatment of uterine scar pregnancy after cesarean section .Methods:A total of 50 patients with uterine scar pregnancy after cesarean section were selected and randomly divided into observation group and control group ,with 25 patients in each group .The patients in the control group were treated with dilatation and curettage , while the patients in the observation group were treated with uterine artery embolization combined with curettage with methotrexate .After treatment ,the clinical efficacy ,the blood loss ,the time of serum β‐human chorionic gonadotropin (β‐HCG) returning to normal level ,the time of endo‐uterine mass disappearing ,the patient's hospital stay and adverse effects ,were compared between the patients in the two groups .Results:The cure rate of patients in the observation group (100% ) was significantly higher than that (64% ) in the control group(P<0 .05);the blood loss (47 .1 ± 14 .2)mL ,the time of endo‐uterine mass disappearing (23 .6 ± 23 .7) d and hospital stay (13 .2 ± 4 .3) d of patients in the observation group were significantly lower than those in the control group [(322 .1 ± 105 .2) mL ,(80 .4 ± 78 .3) d ,(20 .1 ± 7 . 8)d ,P<0 .05)];there was no occurrence of severe complications in the two groups .Conclusions:Vascular intervention in the treatment of uterine scar pregnancy after cesarean section can effectively kill the embryo tissues ,reduce the blood loss ,and retaln the womb as well as the fertility .