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宫腔镜刮宫术前垂体后叶素注射与子宫动脉栓塞术治疗Ⅰ型剖宫产瘢痕妊娠的对比:一项回顾性研究

Pituitrin Injection before Hysteroscopic Curettage for Treating Type I Cesarean Scar Pregnancy in Comparison with Uterine Artery Embolization: A Retrospective Study.

作者信息

Rahman Juveria, Qiu Yixuan, Yuan Xiong, Kassim Sajjaad H, Ji Tonghui, Dai Huihua

机构信息

Department of Gynecology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, 300 Guangzhoulu, Gulou District, Nanjing, Jiangsu 210029 China.

Nanjing Medical University, Nanjing, Jiangsu 210029 China.

出版信息

J Obstet Gynaecol India. 2023 Jun;73(3):229-234. doi: 10.1007/s13224-022-01724-w. Epub 2022 Dec 18.

Abstract

BACKGROUND

The effectiveness and safety of pituitrin injection coupled with hysteroscopy and suction curettage as treatment for type I cesarean scar pregnancy (CSP) have not been studied enough in the literature, by comparing it to uterine artery embolization (UAE) followed by suction curettage we aim to determine its efficacy.

MATERIALS AND METHODS

Data of 53 patients (the PIT group) with type I CSP treated with pituitrin injection combined with hysteroscopic suction curettage and 137 patients (the UAE group) with type I CSP treated with UAE followed by suction curettage were collected in retrospect. The clinical data were analyzed statistically to compare the efficacy and safety between the two groups.

RESULTS

The PIT group had a shorter duration of postoperative vaginal bleeding, postoperative hospitalization, and overall hospitalization length ( < 0.05). The PIT group had lower overall hospitalization costs and a lower rate of adverse events than the UAE group ( < 0.05). There was no significant difference between the two groups in terms of treatment success rate, the average length of operation, blood loss during the procedure, time when serum -hCG returned to normal range, and menstrual recovery time after hospital release ( > 0.05).

CONCLUSION

UAE and pituitrin injection followed by hysteroscopic suction curettage are good choices for type I CSP treatment. However, pituitrin injection with hysteroscopic suction curettage outperforms UAE followed by suction curettage. Thus, pituitrin injection may be an option of high priority for type I CSP.

摘要

背景

垂体后叶素注射联合宫腔镜及刮宫术治疗Ⅰ型剖宫产瘢痕妊娠(CSP)的有效性和安全性在文献中尚未得到充分研究,通过与子宫动脉栓塞术(UAE)后刮宫术进行比较,我们旨在确定其疗效。

材料与方法

回顾性收集53例接受垂体后叶素注射联合宫腔镜刮宫术治疗的Ⅰ型CSP患者(垂体后叶素组)和137例接受UAE后刮宫术治疗的Ⅰ型CSP患者(UAE组)的数据。对临床资料进行统计学分析,比较两组的疗效和安全性。

结果

垂体后叶素组术后阴道出血持续时间、术后住院时间及总住院时间均较短(P<0.05)。垂体后叶素组总住院费用低于UAE组,不良事件发生率也低于UAE组(P<0.05)。两组在治疗成功率、平均手术时间、术中出血量、血清β-hCG恢复正常范围的时间以及出院后月经恢复时间方面无显著差异(P>0.05)。

结论

UAE和垂体后叶素注射联合宫腔镜刮宫术都是治疗Ⅰ型CSP的良好选择。然而,垂体后叶素注射联合宫腔镜刮宫术的效果优于UAE后刮宫术。因此,垂体后叶素注射可能是Ⅰ型CSP的优先选择方案。

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