论文部分内容阅读
目的探讨阴式剖宫产术后瘢痕妊娠病灶切除术的临床应用价值。方法选取2012年1月-2014年1月该院入院时彩色多普勒超声或CT、MRI提示瘢痕妊娠及术后病检结果为瘢痕妊娠的患者60例。将阴式剖宫产术后瘢痕妊娠病灶切除术分别与子宫动脉栓塞介入治疗联合清宫术、米非司酮+甲氨蝶呤药物治疗联合清宫术在血β-人绒毛膜促性腺激素(β-h CG)水平和恢复正常时间、治疗效果、出血量、治疗费用、住院时间、月经恢复时间、有效率进行比较。结果对于血β-h CG值<6 000 IU/L或包块直径≤3 cm的患者,观察组治疗后第1、4、7、14 d的血β-h CG值、血β-h CG值下降为正常所需天数、出血量、住院时间、月经恢复时间显著低于对照组,治疗费用显著高于对照组,差异均有统计学意义(P<0.05)。对于血β-h CG值>6 000 IU/L或者3 cm<包块直径≤5 cm的患者,观察组治疗后第1、4、7、14 d的血β-h CG值、血β-h CG值下降为正常所需天数、出血量、治疗费用、住院时间、月经恢复时间显著低于对照组,差异有统计学意义(P<0.05)。结论阴式剖宫产术后瘢痕妊娠病灶切除术与药物治疗、介入治疗相比具有微创、快捷、疗效佳的优点,适合各层次医院开展。
Objective To investigate the clinical value of excision of scar pregnancy after vaginal cesarean section. Methods From January 2012 to January 2014, 60 cases of patients with scar pregnancy were screened by color Doppler ultrasound, CT and MRI after admission. The vaginal cesarean section after scar removal of pregnancy and uterine artery embolization interventional surgery combined with curettage, mifepristone + methotrexate combined with curettage in serum β-human chorionic gonadotropin (β -h CG) levels and return to normal time, treatment, bleeding, treatment costs, hospital stay, menstrual recovery time, the efficiency of the comparison. Results For patients with a blood β-h CG value of <6 000 IU / L or a mass of ≤ 3 cm, β-h CG, β-h CG The values of days, blood loss, hospitalization time and menstruation recovery time were significantly lower than those of the control group, and the treatment costs were significantly higher than those of the control group (P <0.05). For patients with a blood β-h CG value of> 6,000 IU / L or a diameter of 3 cm <5 cm, the β-h CG values at the 1st, 4th, 7th, h CG value decreased to the normal number of days, the amount of bleeding, treatment costs, hospital stay, menstruation recovery time was significantly lower than the control group, the difference was statistically significant (P <0.05). Conclusion After vaginal cesarean section scar pregnancy resection with drug treatment, interventional treatment compared with minimally invasive, quick, good effect, suitable for all levels of hospitals.