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目的分析药物、子宫动脉栓塞与手术方案治疗剖宫产术后瘢痕妊娠(CSP)的临床效果与安全性。方法以65例CSP患者为研究对象,按照其治疗方案分为药物治疗组(n=19)、动脉栓塞组(n=25)和手术治疗组(n=21),比较各组患者治疗效果与安全性。结果治疗后,手术治疗组血人绒毛膜促性腺激素(HCG)下降率显著高于药物治疗组,动脉栓塞组血HCG下降率显著高于手术治疗组,差异均有统计学意义(P<0.05)。各组患者治疗前后白细胞、血红蛋白、红细胞、红细胞比容均未见明显变化(P>0.05)。动脉栓塞组出血量、住院时间、月经恢复时间、出血量≥50 ml患者占比均显著低于药物治疗组和手术治疗组(P<0.05),其治疗成功率显著高于药物治疗组和手术治疗组(P<0.05)。手术治疗组治疗费用显著高于药物治疗组和动脉栓塞组(P<0.05)。各组不良反应发生率比较,差异无统计学意义(P>0.05)。结论动脉栓塞治疗CSP能够取得更为理想的疗效及安全性,且患者恢复速度较快,具有较佳的临床推广价值。
Objective To analyze the clinical effects and safety of drugs, uterine artery embolization and surgical treatment of cesarean pregnancy after scar pregnancy (CSP). Methods Sixty-five patients with CSP were enrolled in this study. The patients were divided into medication group (n = 19), arterial embolism group (n = 25) and surgery group (n = 21) safety. Results After treatment, the rate of descending HCG in the surgical treatment group was significantly higher than that in the drug-treated group. The rate of HCG decrease in the arterial embolization group was significantly higher than that in the surgical treatment group (P <0.05) ). Before and after treatment, the leukocyte, hemoglobin, erythrocyte and hematocrit in each group had no significant changes (P> 0.05). The proportion of bleeding in arterial embolization group, hospitalization time, menstruation recovery time and the amount of hemorrhage≥50 ml were significantly lower than that of drug-treated group and surgical group (P <0.05), and the success rate of treatment was significantly higher than that of drug-treated group and operation Treatment group (P <0.05). Surgical treatment group cost was significantly higher than the drug treatment group and arterial embolization group (P <0.05). The incidence of adverse reactions in each group, the difference was not statistically significant (P> 0.05). Conclusion Arterial embolization CSP can achieve better efficacy and safety, and patients recover faster, with better clinical value.