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评估经阴道吸引术治疗剖宫产术后子宫瘢痕妊娠患者时子宫下段厚度的价值。

Lower uterine segment thickness in assessing whether cesarean scar pregnancy patients could be treated with suction curettage.

机构信息

Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

J Matern Fetal Neonatal Med. 2020 Oct;33(19):3332-3337. doi: 10.1080/14767058.2018.1531118. Epub 2018 Oct 29.

Abstract

To find a suitable indicator in selecting appropriate patients with cesarean scar pregnancy (CSP) for treatment with ultrasound-guided suction curettage alone. A retrospective review of all women with CSP treated at the Tongji Hospital, Wuhan, China, between 1 January 2013 and 31 December 2015 was conducted. The women were grouped according to the following management options: ultrasound-guided suction curettage only (Group 1); combination with other therapeutic options (Group 2). The clinical characteristics and outcomes were analyzed. Of 174 patients with lower uterine segment myometrium thickness ≥0.2 cm, 93 (53.4%) patients underwent ultrasound-guided suction curettage only, 81 (46.6%) patients underwent a combination with other therapeutics. Clinical characteristics of women who underwent ultrasound-guided suction curettage alone did not significantly differ from those who were treated with combination. Intraoperative blood loss and length of stay differed significantly between the two groups. In appropriate CSP cases with lower uterine segment myometrium thickness more than 0.2 cm, ultrasound-guided suction curettage appears to be a reliable treatment option producing satisfying success rates, lower blood loss, and a shorter hospital-stay compared to combined therapies.

摘要

为了找到一种合适的指标,以便在单独使用超声引导抽吸刮宫术治疗剖宫产瘢痕妊娠(CSP)时选择合适的患者。回顾性分析了 2013 年 1 月 1 日至 2015 年 12 月 31 日期间在中国武汉同济医院接受治疗的所有 CSP 患者。根据以下管理选择将患者分组:仅超声引导抽吸刮宫术(组 1);联合其他治疗选择(组 2)。分析了临床特征和结局。在肌层厚度≥0.2cm 的 174 例患者中,93 例(53.4%)患者仅接受超声引导抽吸刮宫术,81 例(46.6%)患者接受联合治疗。单独接受超声引导抽吸刮宫术的患者的临床特征与接受联合治疗的患者无显著差异。两组术中出血量和住院时间差异有统计学意义。对于肌层厚度大于 0.2cm 的合适 CSP 病例,与联合治疗相比,超声引导抽吸刮宫术似乎是一种可靠的治疗选择,可产生令人满意的成功率、较低的出血量和较短的住院时间。

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