临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2015年
15期
1291-1294
,共4页
瘢痕部位妊娠%剖宫产%药物保守治疗%子宫动脉栓塞术%子宫瘢痕修补术%妊娠病灶切除术
瘢痕部位妊娠%剖宮產%藥物保守治療%子宮動脈栓塞術%子宮瘢痕脩補術%妊娠病竈切除術
반흔부위임신%부궁산%약물보수치료%자궁동맥전새술%자궁반흔수보술%임신병조절제술
Cesarean scar pregnancy%Medicine conservative treatment%Uterine artery embolization%Uterine scar repair%Pregnancy re-section of the lesions
目的：研究剖宫产瘢痕部位妊娠的临床治疗方式及疗效。方法选取2008年12月至2015年3月妇科收治的90例临床确诊剖宫产瘢痕部位妊娠患者作为研究对象，回顾性分析不同治疗方法的疗效。将90例患者按不同治疗方法随机分组，A 组患者24例，行药物保守治疗（米非司酮联合甲氨喋呤），B 组患者28例行腹腔镜下妊娠病灶切除术+子宫修补术；C 组38例患者行子宫动脉栓塞术治疗。比较研究三组患者的临床治疗效果。结果①与治疗前相比，治疗后三组患者血β- HCG 水平均明显降低（ P ﹤0.05），组间β- HCG 水平比较 A 组﹥ B 组﹥ C 组，差异有统计学意义（ P ﹤0.05）；②各项激素水平组间比较无显著性差异（ P ﹥0.05）；③在月经恢复时间、血β- HCG 恢复正常耗时、阴道流血时间、流血量、住院时间等指标上，C 组﹤ B 组﹤ A 组，统计学 F 检验，差异有显著性（ P ﹤0.05）。结论三种治疗方式均能够保留子宫及卵巢功能，符合有生育要求患者，其中子宫动脉栓塞术治疗患者治愈耗时短，创伤小，恢复快，临床推荐应用。
目的：研究剖宮產瘢痕部位妊娠的臨床治療方式及療效。方法選取2008年12月至2015年3月婦科收治的90例臨床確診剖宮產瘢痕部位妊娠患者作為研究對象，迴顧性分析不同治療方法的療效。將90例患者按不同治療方法隨機分組，A 組患者24例，行藥物保守治療（米非司酮聯閤甲氨喋呤），B 組患者28例行腹腔鏡下妊娠病竈切除術+子宮脩補術；C 組38例患者行子宮動脈栓塞術治療。比較研究三組患者的臨床治療效果。結果①與治療前相比，治療後三組患者血β- HCG 水平均明顯降低（ P ﹤0.05），組間β- HCG 水平比較 A 組﹥ B 組﹥ C 組，差異有統計學意義（ P ﹤0.05）；②各項激素水平組間比較無顯著性差異（ P ﹥0.05）；③在月經恢複時間、血β- HCG 恢複正常耗時、陰道流血時間、流血量、住院時間等指標上，C 組﹤ B 組﹤ A 組，統計學 F 檢驗，差異有顯著性（ P ﹤0.05）。結論三種治療方式均能夠保留子宮及卵巢功能，符閤有生育要求患者，其中子宮動脈栓塞術治療患者治愈耗時短，創傷小，恢複快，臨床推薦應用。
목적：연구부궁산반흔부위임신적림상치료방식급료효。방법선취2008년12월지2015년3월부과수치적90례림상학진부궁산반흔부위임신환자작위연구대상，회고성분석불동치료방법적료효。장90례환자안불동치료방법수궤분조，A 조환자24례，행약물보수치료（미비사동연합갑안첩령），B 조환자28례행복강경하임신병조절제술+자궁수보술；C 조38례환자행자궁동맥전새술치료。비교연구삼조환자적림상치료효과。결과①여치료전상비，치료후삼조환자혈β- HCG 수평균명현강저（ P ﹤0.05），조간β- HCG 수평비교 A 조﹥ B 조﹥ C 조，차이유통계학의의（ P ﹤0.05）；②각항격소수평조간비교무현저성차이（ P ﹥0.05）；③재월경회복시간、혈β- HCG 회복정상모시、음도류혈시간、류혈량、주원시간등지표상，C 조﹤ B 조﹤ A 조，통계학 F 검험，차이유현저성（ P ﹤0.05）。결론삼충치료방식균능구보류자궁급란소공능，부합유생육요구환자，기중자궁동맥전새술치료환자치유모시단，창상소，회복쾌，림상추천응용。
Objective The aim of this study is to investigate the clinical treatment and therapeutic effect of cesarean scar pregnancy. Methods Between December 2008 to March 2015,the records of 90 cases of gynecologic clinical diagnosis of cesarean scar pregnancy patients were included into this study. The curative effect of different treatments and the influence on ovarian function were retrospectively analyzed. All these patients were be randomly assigned according to the different treatment,24 patients with group A undergoing line medicine conservative treat-ment(mifepristone combined methotrexate),group B 28 patients undergoing laparoscopic resection of the lesions of pregnancy + uterine defect re-pair;C group of 38 cases of patients with uterine artery embolization. The clinical therapeutic effect and safety of three groups of patients were com-pared. Results ①The three groups of patients with blood βHCG levels were significantly reduced compared with before treatment( P ﹤ 0. 05), the comparison between groups(group A ﹥ group B ﹥ group C)had statistically significant( P ﹤ 0. 05). ②The hormone levels between groups was no significant difference( P ﹥ 0. 05). ③The recovery time in the menstrual cycle and blood β HCG normal time - consuming,vaginal bleed-ing time,bleeding volume,length of hospital stay on indicators,time consuming group C ﹤ group B ﹤ group A,statistically F test,there were significant difference( P ﹤ 0. 05). Conclusion Three kinds of treatment are to preserve the uterus and ovarian function,conform to the require-ments of the have fertility patients,uterine artery embolization in patients with short cure time,little trauma,quick recovery. Therefore,this treat-ment was recommended the uterine artery embolization to treatment uterine scar pregnancy.
