超声评分系统指导下剖宫产瘢痕妊娠不同处理方式的安全性及有效性评价

黄强; 项锦红; 罗莉; 陈正琼; 孙秋蕾

doi:10.16016/j.1000-5404.202005293

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超声评分系统指导下剖宫产瘢痕妊娠不同处理方式的安全性及有效性评价

临床医学 | 更新时间：2026-01-09

- 超声评分系统指导下剖宫产瘢痕妊娠不同处理方式的安全性及有效性评价
- Evaluation on safety and effectiveness of ultrasonographic scoring system in different treatment methods for cesarean scar pregnancy
- 第三军医大学学报 2020年42卷第21期页码：2128-2133
- 作者机构：
  
  400037 重庆，陆军军医大学(第三军医大学)第二附属医院妇产科
- 作者简介：
  
  [孙秋蕾，E-mail:sunqiulei1234@163.com SUN Qiulei, E-mail: sunqiulei1234@163.com
- 基金信息：
  
  重庆市科技局技术创新与应用发展面上项目(CSTC2019jscx-msxmX0269)
- DOI：10.16016/j.1000-5404.202005293
  中图分类号： R445.1;R619.6;R714.2
- 收稿：2020-05-31，
  
  修回：2020-08-25，
  
  纸质出版：2020-11-15
- 稿件说明：
移动端阅览
黄强, 项锦红, 罗莉, 等. 超声评分系统指导下剖宫产瘢痕妊娠不同处理方式的安全性及有效性评价[J]. 第三军医大学学报, 2020,42(21):2128-2133.

Qiang HUANG, Jinhong XIANG, Li LUO, et al. Evaluation on safety and effectiveness of ultrasonographic scoring system in different treatment methods for cesarean scar pregnancy[J]. Journal of Third Military Medical University, 2020, 42(21): 2128-2133.
黄强, 项锦红, 罗莉, 等. 超声评分系统指导下剖宫产瘢痕妊娠不同处理方式的安全性及有效性评价[J]. 第三军医大学学报, 2020,42(21):2128-2133. DOI： 10.16016/j.1000-5404.202005293.

Qiang HUANG, Jinhong XIANG, Li LUO, et al. Evaluation on safety and effectiveness of ultrasonographic scoring system in different treatment methods for cesarean scar pregnancy[J]. Journal of Third Military Medical University, 2020, 42(21): 2128-2133. DOI： 10.16016/j.1000-5404.202005293.

摘要

目的

对超声评分系统下不同风险组剖宫产瘢痕妊娠不同处理方式的安全性及有效性进行比较和评价。

方法

回顾性分析2018年11月至2019年12月于陆军军医大学第二附属医院妇产科住院手术治疗的299例剖宫产瘢痕部位妊娠的病例资料。根据术前超声评分系统将患者分为高风险组(评分>4分)和低风险组(评分≤4分)，低风险组行B超引导下清宫术，高风险组行子宫动脉栓塞术+B超引导下清宫术。收集患者基本信息、围术期资料及术后随访资料并进行统计学分析。

结果

两组患者术中出血量差异无统计学意义。两组治疗后需再次行子宫动脉栓塞术的发生率差异无统计学意义

而需要再次腹腔镜下瘢痕妊娠病灶去除术的发生率差异有统计学意义(

0.05)。两组患者住院时间和花费差异有统计学意义(

0.05)。两组患者术后血清β-HCG水平恢复至正常的时间、B超子宫下段异常回声消失的时间、月经恢复正常的时间差异均有统计学意义(

0.05)。而治疗后两组患者再次妊娠的结局差异无统计学意义。

结论

根据术前超声评分系统，对不同风险组的剖宫产瘢痕妊娠选择相应的处理方式均安全有效。

Abstract

Objective

To evaluate and compare the efficacy and safety of different managements for women with cesarean scar pregnancy based on a ultrasonographic scoring system.

Methods

A total of 299 pregnant women with cesarean scar undergoing delivery surgeries in our department from November 2018 to December 2019 were recruited retrospectively. According to the preoperative results of the ultrasonographic scoring system

they were divided into low-risk group (score ≤4) and high-risk group (score > 4). The patients in the low-risk group were treated with ultrasound-guided curettage. And those of the other group were treated with uterine artery embolization and ultrasound-guided curettage. The basic information

perioperative data and postoperative follow-up data of the patients were collected and analyzed.

Results

There was no statistical difference in the amount of intraoperative blood loss between the 2 groups (

0.05)

neither the incidence of secondary uterine artery embolization between them (

0.05). But significant difference was found in the incidence of secondary laparoscopic procedure for removing scar tissues between the 2 groups (

0.05). What's more

there were obvious differences in the length of hospital stay and total cost

the time of postoperative serum β-HCG level dropping to normal

the time of disappearance of the abnormal echoes in the lower segment of the uterus

and the restoration of normal menstruation between the 2 groups (

0.05). However

there was no statistical significance of the outcome of the second pregnancy between them after treatment.

Conclusion

According to the preoperative ultrasonographic scoring system for cesarean scar pregnancy

patients in different treatment methods.

关键词

Keywords

references

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