垂体后叶素联合宫腔镜下清宫术治疗Ⅰ型剖宫产瘢痕妊娠
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江苏省卫生厅面上科研项目(H201404)


Combination of pituitrin injection and hysteroscopic suction curettage for treating TypeⅠcesarean scar pregnancy
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    摘要:

    目的:探讨垂体后叶素联合宫腔镜下清宫术治疗Ⅰ型剖宫产瘢痕妊娠(cesarean scar pregnancy,CSP)的临床疗效。方法:2016年11月—2018年7月,就诊于南京医科大学第一附属医院的Ⅰ型剖宫产术后CSP患者,21例选择子宫颈体交界处注射垂体后叶素联合宫腔镜下清宫术(试验组),对比同期行双侧子宫动脉栓塞术(uterine artery embolization,UAE)联合清宫术(对照组)83病例,比较两组临床疗效。结果:试验组术后阴道出血时间、术后住院时间、总住院时间均短于对照组,试验组总住院费用少于对照组,试验组治疗后不良反应发生比例低于对照组,差异均有统计学意义(P < 0.05)。试验组治疗成功率、平均手术时间、术中出血量、术后血清人绒毛膜促性腺激素(β-HCG)下降至正常时间、术后月经复潮时间与对照组比较,差异无统计学意义(P > 0.05)。结论:垂体后叶素联合宫腔镜下清宫术与双侧子宫动脉介入后行清宫术治疗Ⅰ型剖宫产CSP的临床疗效确切。与双侧子宫动脉介入栓塞联合清宫术相比,清宫术前注射垂体后叶素有明显优势,值得推广。

    Abstract:

    Objective:To evaluate the efficacy and safety of pituitrin injection combined with hysteroscopy and suction curettage for typeⅠcesarean scar pregnancy(CSP). Methods:From November 2016 to July 2018,21 patients(the experimental group)with typeⅠ CSP in the First Affiliated Hospital of Nanjing Medical University were treated with pituitrin injection combined with hysteroscopic suction curettage,while 83 patients(the control group)with typeⅠCSP were treated with uterine artery embolization(UAE)followed by suction curettage as first-line therapy. The clinical data were analyzed with statistics to compare the efficacy and safety between the two groups. Results:The time of postoperative vaginal bleeding,postoperative hospitalization and the total hospitalization duration was shorter in the experimental group(P < 0.05).The total hospitalization expenses and the occurrence rate of adverse reactions were lower in the experimental group than the control group(P < 0.05).There was no significant difference in the treatment success rate,the average operative duration,the intraoperative blood loss,the time when serum β-HCG return to the normal range and the recovery time of menstruation after hospital discharge between the two groups(P > 0.05). Conclusion:For TypeⅠCSP,both UAE followed by suction curettage and pituitrin injection combined with hysteroscopic suction curettage appear to be nice options. However pituitrin injection combined with hysteroscopic suction curettage possesses an apparent advantage over UAE followed by suction curettage. It may be a priority option for typeⅠCSP.

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吴 菁,孙 莹,晋一超,袁 雄,纪统慧,戴辉华.垂体后叶素联合宫腔镜下清宫术治疗Ⅰ型剖宫产瘢痕妊娠[J].南京医科大学学报(自然科学版),2019,(2):242-246

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  • 收稿日期:2018-09-13
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  • 在线发布日期: 2019-03-06
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