生殖医学杂志2017，Vol.26Issue(9)：885-890,6.DOI:10.3969/j.issn.1004-3845.2017.09.007
剖宫产瘢痕妊娠两种手术治疗方式安全性及有效性的比较
Comparison of efficacy and safety of two surgical treatments for cesarean scar pregnancy
摘要
Abstract
Objective:To compare the efficacy and safety of hysterotomy by laparotomy combined with repair of lower uterine segment and uterine artery embolization combined with dilation and curettage for the surgical treatment of cesarean scar pregnancy.Methods:A total of 245 patients with cesarean scar pregnancy received treatment in Peking Union Medical College Hospital from 2009 to 2014.Among them,100 patients who met the inclusion criteria of our study were randomly divided into two groups according to their treatment:The patients in group A received hysterotomy by laparotomy combined with repair of the lower uterine segment.The patients in group B received uterine artery embolization combined with dilation and curettage.The basic information,perioperative data and follow-up data of the 100 patients were collected and analyzed.Results:The overall cure rate (98.0％ vs.96.0％) was not significantly different between group A and group B (P＞0.05).The amount of intraoperative bleeding in group B were significantly lower than that in group A [(95.0±48.4) ml vs.(23.0±17.6) ml] (P=0.000).The median time for serum β-HCG remission after treatment in group A were significantly less than that in group B [(30.7±10.7) vs.(34.7±9.6) days] (P＜0.05).No significant difference was found in the median time for uterine mass disappearance after treatment between two groups [(35.7± 10.8) vs.(24.4± 13.6) days] (P＞0.05).The median operation time was significantly longer in group A than that in group B [(77.0±15.0) vs.(30.0±16.0) min)] (P=0.00).The median hospitalization cost in group A was significantly lower than that in group B [(7 919.6±3 680.6)vs.(15 285.6±2 962.9) RMB] (P=0.00).The median time of menstruation after treatment by telephone follow up was significantly shorter in group A than that in group B [(37.4±10.5) vs.(41.2±13.8) days] (P＜0.05).Conclusions:Hysterotomy by laparotomy combined with repair of the lower uterine segment and uterine artery embolization combined with dilation and curettage are both safe and effective treatment for cesarean scar pregnancy.关键词
剖宫产瘢痕妊娠/子宫动脉栓塞术/清宫术Key words
Cesarean scar pregnancy/Uterine artery embolization/Dilatation and curettage引用本文复制引用
陈娜,彭萍,刘欣燕,欧婕,李瑾瑾,吴琳琳..剖宫产瘢痕妊娠两种手术治疗方式安全性及有效性的比较[J].生殖医学杂志,2017,26(9):885-890,6.基金项目
首都医学发展科研基金(2009-2004) （2009-2004）
