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子宫动脉栓塞术对剖宫产子宫瘢痕妊娠患者血清β-HCG水平、生育功能及临床疗效的影响

Uterine Artery Embolization on Serum β-HCG Levels, Fertility Function and Clinical Efficacy in Patients With Cesarean Uterine Scar Pregnancy.

作者信息

Zhu Wenyang, Zhang Xiaofang, Liu Chang, Liu Yang, Xu Wei

机构信息

Department of Interventional Radiolody, The Affiliated Huaian Hospital of Xuzhou Medical University, Huaian, China.

Department of Ultrasound, The Huaian Clinical College of Xuzhou Medical University, Huaian Maternity and Children Hospital, Huaian, China.

出版信息

Front Surg. 2022 Feb 2;9:838879. doi: 10.3389/fsurg.2022.838879. eCollection 2022.

Abstract

OBJECTIVE

To analyze the therapeutic effect of uterine artery embolisation (UAE) in patients with cesarean section pregnancy (CSP) delivered by cesarean section and the effect on serum human chorionic gonadotrophin (β-HCG) levels and reproductive function.

METHODS

In total 142 patients with CSP, The control group ( = 71) received Methotrexate (MTX) with ultrasound monitoring after admission and the research group ( = 71) was treated with UAE on basic of the control group. The two groups were compared in terms of treatment outcome, intraoperative bleeding, bed activity, vaginal bleeding and length of hospital stay, and serum follicle stimulating hormone (FSH), oestradiol (E2), luteinising hormone (LH) and β-HCG levels at 1 month postoperatively. The clinical symptoms (normalization of β-HCG and return of menstruation) and clinical outcomes (normal pregnancy, recurrent scar pregnancy) were compared between the two groups, as well as the occurrence of post-operative complications in both groups.

RESULTS

Compared with the control group, the research group had a higher overall near-term effective rate, a lower recurrence rate of CSP in pregnancy, and a lower complication rate ( < 0.05); meanwhile, the time to get out of bed, postoperative vaginal bleeding, length of hospital stay, normalization of serum β-HCG, and return to menstruation were shorter in the research group than in the control group ( < 0.05); In addition, serum FSH, E2, LH and β-HCG levels improved better in the research group compared with the control group 1 month after surgery ( < 0.05).

CONCLUSION

The treatment of CSP patients with UAE can reduce the amount of intraoperative bleeding and the duration of vaginal bleeding, promote the improvement of patients' clinical symptoms, have less impact on the disruption of patients' sex hormone balance, reduce patients' surgical risks to a greater extent, preserve patients' normal fertility, and have better application.

摘要

目的

分析剖宫产术治疗剖宫产术后妊娠(CSP)患者的疗效以及对血清人绒毛膜促性腺激素(β-HCG)水平和生殖功能的影响。

方法

选取142例CSP患者,对照组(n = 71)入院后接受甲氨蝶呤(MTX)并超声监测,研究组(n = 71)在对照组基础上接受子宫动脉栓塞术(UAE)治疗。比较两组的治疗效果、术中出血量、下床活动时间、阴道流血情况及住院时间,以及术后1个月时血清促卵泡生成素(FSH)、雌二醇(E2)、促黄体生成素(LH)和β-HCG水平。比较两组的临床症状(β-HCG恢复正常和月经复潮)和临床结局(正常妊娠、瘢痕妊娠复发),以及两组术后并发症的发生情况。

结果

与对照组相比,研究组近期总有效率更高,CSP妊娠复发率更低,并发症发生率更低(P < 0.05);同时,研究组下床活动时间、术后阴道流血时间、住院时间、血清β-HCG恢复正常时间及月经复潮时间均短于对照组(P < 0.05);此外,术后1个月研究组血清FSH、E2、LH和β-HCG水平改善情况优于对照组(P < 0.05)。

结论

采用UAE治疗CSP患者可减少术中出血量和阴道流血时间,促进患者临床症状改善,对患者性激素平衡紊乱影响较小,更大程度降低患者手术风险,保留患者正常生育能力,具有较好的应用价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58ed/8847222/2ebf8f231c22/fsurg-09-838879-g0001.jpg

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