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目的探讨Ⅱ型瘢痕处妊娠终止方法的临床效果。方法回顾性分析2015年1月至2016年1月郑州大学第一附属医院产科收治的42例Ⅱ型瘢痕处妊娠患者,根据手术方式不同分为三组,收集口服米非司酮+彩超引导下清宫术18例作为A组;收集双侧子宫动脉栓塞术(UAE)+彩超引导下清宫术13例作为B组;收集直接采用彩超引导下清宫术11例作为C组;对比分析三组术中术后治疗效果。结果 B组患者血人绒毛膜促性腺激素(HCG)下降情况优于A、C两组,术中出血量少于A、C两组,住院费用均高于A、C两组,差异有统计学意义(P<0.05);A组患者总住院时间长于B、C两组,差异有统计学意义(P<0.05)。结论对于Ⅱ型瘢痕处妊娠患者,清宫术前行UAE可明显减少患者出血量,但临床并发症也较多,在临床应用过程中应权衡利弊,避免盲目应用UAE。
Objective To investigate the clinical effect of termination of pregnancy in type Ⅱ scar. Methods A retrospective analysis of 42 patients with type Ⅱ scar admitted to the obstetrics department of the First Affiliated Hospital of Zhengzhou University from January 2015 to January 2016 was divided into three groups according to different surgical methods and was collected under the guidance of oral mifepristone plus color Doppler ultrasound 18 cases of radical mastectomy as group A; Bilateral uterine arterial embolization (UAE) + 13 cases of uterine cavity under ultrasound-guided ultrasonography were collected as group B; 11 cases of uterine bleeding under direct ultrasound guided ultrasonography were selected as group C; Postoperative treatment effect. Results The decline of blood human chorionic gonadotropin (HCG) in group B was better than that of group A and C, and the amount of bleeding during operation was less than those in groups A and C. The hospitalization costs were higher than those in groups A and C (P <0.05). The total length of stay of patients in group A was longer than that of group B and C (P <0.05). Conclusion For patients with type Ⅱ scar pregnancy, UAE can significantly reduce the amount of bleeding in the patients before operation. However, there are more clinical complications. UAE should be carefully weighed in the clinical application.