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子宫动脉栓塞术(UAE)与腹腔镜剖宫产瘢痕妊娠清除术(LCSPDS)治疗剖宫产瘢痕妊娠的临床疗效和安全性比较。

Clinical Efficacy and Safety of Uterine Artery Embolization (UAE) versus Laparoscopic Cesarean Scar Pregnancy Debridement Surgery (LCSPDS) in Treatment of Cesarean Scar Pregnancy.

机构信息

Department of Obstetrics and Gynecology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland).

Department of Obstetrics and Gynecology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China (mainland).

出版信息

Med Sci Monit. 2018 Jul 6;24:4659-4666. doi: 10.12659/MSM.907404.

Abstract

BACKGROUND The present study aimed to compare the clinical efficacy and safety of uterine artery embolization (UAE) vs. laparoscopic cesarean scar pregnancy debridement surgery (LCSPDS) in the treatment of patients with cesarean scar pregnancy (CSP). MATERIAL AND METHODS A retrospective analysis was performed on 87 CSP patients from March 2012 to February 2017. For the included 87 cases, 51 were treated with UAE and 36 were treated with LCSPDS. The operation success rate, intraoperative blood loss, operation time, length of hospital stay, perioperative complications, and β-HCG level were compared. RESULTS For the UAE group, 41 patients underwent successful surgeries (80.4% success rate), and 36 cases in the LCSPDS group were successfully treated, with no case of perioperative death. In the UAE group, the operation time, intraoperative blood loss, and length of hospital stay were 82.23±45.21 min, 112.58±68.54 mL, and 12.56±3.03 days, respectively. In the LCSPDS group, the operation time, intraoperative blood loss, and length of hospital stay were 85.45±30.02 min, 108.56±54.12 mL and 7.65±2.48 days, respectively. The length of hospital stay for the UAE group was significantly longer than in the LCSPDS group (P<0.05). CONCLUSIONS UAE and LCSPDS each have their own advantages and disadvantages in treating CSP. Thus, appropriate individualized surgical programs based on specific patient circumstances are needed to avoid indiscriminately performing complete uterine cavity curettage.

摘要

背景

本研究旨在比较子宫动脉栓塞术(UAE)与腹腔镜剖宫产瘢痕妊娠清除术(LCSPDS)治疗剖宫产瘢痕妊娠(CSP)的临床疗效和安全性。

方法

回顾性分析 2012 年 3 月至 2017 年 2 月收治的 87 例 CSP 患者。纳入的 87 例患者中,51 例行 UAE 治疗,36 例行 LCSPDS 治疗。比较两组手术成功率、术中出血量、手术时间、住院时间、围手术期并发症及β-HCG 水平。

结果

UAE 组手术成功率为 80.4%(41/51),LCSPDS 组为 100.0%(36/36),两组均无围手术期死亡病例。UAE 组手术时间、术中出血量、住院时间分别为 82.23±45.21 min、112.58±68.54 mL、12.56±3.03d;LCSPDS 组分别为 85.45±30.02 min、108.56±54.12 mL、7.65±2.48d。UAE 组住院时间明显长于 LCSPDS 组(P<0.05)。

结论

UAE 和 LCSPDS 治疗 CSP 各有优缺点。因此,需要根据患者具体情况制定个体化的手术方案,避免盲目行全子宫腔刮宫术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f37/6069508/fa7bb05a52aa/medscimonit-24-4659-g001.jpg

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