Zhu Xiaogang, Deng Xinliang, Xiao Songshu, Wan Yajun, Xue Min
a Department of Gynecology, Third Xiangya Hospital of Central South University , Changsha , China.
Int J Hyperthermia. 2016;32(2):144-50. doi: 10.3109/02656736.2015.1104733. Epub 2015 Dec 7.
The aim of this study was to retrospectively analyse the clinical data of 122 patients with caesarean scar pregnancy (CSP) treated in our hospital, to compare the outcomes between high-intensity focused ultrasound (HIFU) and uterine artery embolisation (UAE).
Among the 122 patients, 76 patients were treated with HIFU followed by suction curettage under hysteroscopic guidance, 46 patients were treated with UAE followed by suction curettage under hysteroscopic guidance. Pain score, intraoperative blood loss in suction curettage under hysteroscopy guidance, time for vaginal bleeding, β-human chorionic gonadotropin (β-hCG) to return to normal level, normal menstruation recovery, hospital stay, and the adverse effects were all compared.
No statistically significant differences between the two groups in the intraoperative blood loss, hospital stay, time for β-human chorionic gonadotropin (β-hCG) to return to normal level, or time for normal menstruation recovery were observed. The pain score was lower and the adverse effects were fewer in the HIFU group than those in the UAE group. However, the time for vaginal bleeding was longer in the patients treated with HIFU than that of patients treated with UAE.
Based on our results, it appears that either HIFU or UAE combined with suction curettage under hysteroscopic guidance is safe and effective in treating patients with CSP. Compared with UAE, HIFU treatment for CSP has the advantages of a lower pain score and fewer adverse effects.
本研究旨在回顾性分析我院收治的122例剖宫产瘢痕妊娠（CSP）患者的临床资料，比较高强度聚焦超声（HIFU）与子宫动脉栓塞术（UAE）的治疗效果。
122例患者中，76例采用HIFU治疗，随后在宫腔镜引导下行刮宫术；46例采用UAE治疗，随后在宫腔镜引导下行刮宫术。比较两组患者的疼痛评分、宫腔镜引导下刮宫术中出血量、阴道出血时间、β-人绒毛膜促性腺激素（β-hCG）恢复正常水平的时间、月经恢复正常的时间、住院时间及不良反应。
两组患者在术中出血量、住院时间、β-人绒毛膜促性腺激素（β-hCG）恢复正常水平的时间或月经恢复正常的时间方面，差异均无统计学意义。HIFU组的疼痛评分低于UAE组，不良反应也少于UAE组。然而，HIFU治疗患者的阴道出血时间比UAE治疗患者的长。
根据我们的研究结果，HIFU或UAE联合宫腔镜引导下刮宫术治疗CSP患者似乎都是安全有效的。与UAE相比，HIFU治疗CSP具有疼痛评分更低、不良反应更少的优点。
