中国实用妇科与产科杂志2024，Vol.40Issue(9)：932-936,5.DOI:10.19538/j.fk2024090117
聚焦超声消融手术治疗剖宫产瘢痕妊娠多中心研究
A multicenter study on focused ultrasound ablation surgery for cesarean scar pregnancy
摘要
Abstract
Objective To investigate the clinical efficacy of focused ultrasound ablation surgery(FUAS)for different types of cesarean scar pregnancy(CSP)and the factors affecting bleeding volume and readmission.Methods From January 2014 to December 2023,1581 patients with cesarean scar pregnancy were treated by FUAS in the 3rd Xiangya Hospital of Central South University,Hunan Maternal and Child Health Care Hospital,and Chenzhou First People's Hospital,and their data were retrospectively analyzed.The efficacy and safety of FUAS for different types of CSP,and the influencing factors of bleeding volume and readmission were analyzed.Results All the patients completed FUAS successfully in one session.After FUAS,color Doppler ultrasound showed a significant decrease in blood flow signal,while contrast-enhanced ultrasound showed no enhancement in the treated area.The median volume of blood loss in curettage was 20mL(range:5-950mL).The amount of bleeding volume more than 200mL was observed in 62 patients(4.4％,62/1425),and 64 patients(4.0％,64/1581)were readmitted after curettage.The blood supply of the mass(P=0.006)and the largest diameter of the mass(P=0.03)were the risk factors affecting the amount of bleeding during curettage.The lesions with blood supply of grades 3-4 and the size larger than 30.5mm were more likely to lead to major bleeding.The risk of readmission was related to the type of CSP(P=0.01),and the risk of readmission of patients was increased by 3rd type of CSP.No serious complications such as intestinal and nerve injury occurred during FUAS.Conclusions FUAS combined with curettage is safe and effective in the treatment of different types of CSP.The blood supply of grades 3-4 and the largest diameter more than 30.5mm of the lesion are more likely to result in bleeding,and the patients with 3rd type CSP have a higher risk of readmission.关键词
剖宫产瘢痕妊娠/聚焦超声消融手术/有效性/安全性/影响因素Key words
cesarean scar pregnancy/focused ultrasound ablation surgery/effectiveness/safety/influencing factors分类
医药卫生引用本文复制引用
朱小刚,熊黎,何昌晖,余鸿凡,彭丽秀,程卫,薛敏..聚焦超声消融手术治疗剖宫产瘢痕妊娠多中心研究[J].中国实用妇科与产科杂志,2024,40(9):932-936,5.基金项目
超声医学工程国家重点实验室开放课题(2020KFA3001) （2020KFA3001）
中国博士后科学基金(2021M700639) （2021M700639）
重庆市博士后科研项目 （）
湖南省妇幼保健院"锐新"培育项目(2021RX28) （2021RX28）
超声医学工程国家重点实验室开放课题(2023KFKT012) （2023KFKT012）
