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目的观察剖宫产瘢痕妊娠(CSP)行B超引导下吸宫联合选择性宫腔水囊压迫治疗的临床效果。方法选取湖州市妇幼保健院2014年5月-2016年5月收治的CSP患者80例,随机分为B超引导下吸宫联合选择性宫腔水囊压迫治疗组(联合治疗组,40例)和甲氨蝶呤(MTX)治疗后宫腔水囊压迫治疗组(单独治疗组,40例),对两组患者的临床疗效、子宫切口局部血肿形成情况、手术时间、总失血量、术后血β-h CG降到正常时间、月经复潮时间、子宫切口局部血肿吸收时间、住院时间进行统计分析。结果两组患者的手术成功率95.0%(38/40)vs.92.5%(37/40)比较,差异无统计学意义(P>0.05);两组患者的子宫切口局部血肿形成率40.0%(16/40)vs.42.5%(17/40)比较,差异无统计学意义(P>0.05);联合治疗组患者的总失血量(74.2±55.3)ml显著少于单独治疗组(657.1±304.2)ml,差异有统计学意义(P<0.05);联合治疗组患者的住院时间(11.2±3.2)d显著短于单独治疗组(19.6±5.1)d,差异有统计学意义(P<0.05);两组患者的手术时间[(27.2±10.3)min vs.(24.1±4.2)min]比较,差异无统计学意义(P>0.05);两组患者的术后血β-h CG水平降到正常时间比较,差异无统计学意义(P>0.05);两组患者的月经复潮时间比较,差异无统计学意义(P>0.05);两组患者的子宫切口局部血肿吸收时间差异无统计学意义(P>0.05)。结论 CSP行B超引导下吸宫联合选择性宫腔水囊压迫治疗的临床可行性较单纯选择性宫腔水囊压迫治疗疗效高,联合治疗更能有效减少患者的总失血量,缩短患者的住院时间。
Objective To observe the clinical effect of cesarean scar pregnancy (CSP) under ultrasound-guided suction combined with selective intrauterine compression. Methods Eighty patients with CSP admitted to Huzhou MCH from May 2014 to May 2016 were randomly divided into two groups: control group (40 cases) and control group And methotrexate (MTX) after intrauterine compression treatment group (monotherapy group, 40 cases), the clinical efficacy of two groups of patients, uterine incision hematoma formation, operation time, total blood loss, postoperative blood β-h CG down to normal time, menstrual recuperation time, uterine incision hematoma absorption time, hospitalization for statistical analysis. Results The success rate of operation was 95.0% (38/40) vs 92.5% (37/40) in the two groups, with no significant difference (P> 0.05). The incidence of local hematoma in the two groups was 40.0% (74.2 ± 55.3) ml in the combined treatment group was significantly less than that in the untreated group (657.1 ± 304.2 vs 16.5%, 17/40) (P> 0.05) ), the difference was statistically significant (P <0.05). The hospitalization time in the combined treatment group (11.2 ± 3.2) d was significantly shorter than that in the monotherapy group (19.6 ± 5.1) d, the difference was statistically significant (P0.05) (P <0.05). The postoperative blood β-h CG level in both groups decreased to (27.2 ± 10.3) min vs. (24.1 ± 4.2) min] There was no significant difference in the normal time (P> 0.05). There was no significant difference in the time of menstrual resuscitation between the two groups (P> 0.05). There was no significant difference in the time of local hematoma absorption between the two groups Significance (P> 0.05). Conclusion CSP under the guidance of the B-ultrasound combined with selective intrauterine compression combined with intrauterine compression of the uterine cavity is more effective than the selective intrauterine compression. The combination therapy can effectively reduce the total amount of blood loss and shorten the patients’ Hospitalization time.