Observation on the clinical efficacy of pituitrin combined with hysteroscopic negative pressure hysteroscopy in the treatment of type Ⅱ cesarean scar pregnancy
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摘要: 目的 观察垂体后叶素联合宫腔镜下负压清宫术对Ⅱ型剖宫产子宫瘢痕妊娠术后恢复及不良反应的影响。 方法 以自2017年4月—2019年4月泸州市妇幼保健院产科收治的180例Ⅱ型剖宫产子宫疤痕妊娠患者为研究对象,按照随机数字表方法分为对照组和研究组,各90例。对照组患者予以双侧子宫动脉栓塞联合宫腔镜下负压清宫术,研究组患者予以垂体后叶素注射联合宫腔镜下负压清宫术。统计患者手术持续时间、术中出血量、术后阴道出血持续时间、住院时间、β-hCG恢复正常时间、术后月经恢复时间、月经恢复周期和月经持续时间,观察患者术后不良反应情况。 结果 研究组患者清宫术中出血量[(23.67±3.47)mL]显著少于对照组患者[(34.81±6.95)mL],术后阴道出血持续时间[(5.84±1.62)d]及住院时间[(5.07±1.38)d]显著短于对照组的[(9.36±2.49)d、(8.42±2.01)d],差异有统计学意义(均P<0.001)。研究组患者术后月经恢复时间[(37.96±3.85)d]显著短于对照组[(42.72±4.03)d],差异有统计学意义(t=-8.825,P<0.001)。研究组术后下腹坠痛和下肢麻木疼痛不良反应发生率分别为1.11%和0.00%,显著低于对照组的8.89%和6.67%(χ2=4.211、4.310,P=0.040、0.038)。 结论 较双侧子宫动脉栓塞,垂体后叶素注射后行宫腔镜下负压清宫术,可显著降低术中出血量,促进术后康复,缩短月经和排卵功能恢复周期,降低术后不良反应发生率,安全性较高。Abstract: Objective To observe the effect of pituitrin combined with hysteroscopic negative pressure cleaning on the recovery and adverse reactions of type Ⅱ cesarean scar pregnancy. Methods A total of 180 cases of type Ⅱ cesarean scar pregnancy whom were admitted to obstetrics department of Luzhou maternal and child health hospital from April 2017 to April 2019 were as the research object, all the patients were divided into control group(n=90) and research group(n=90) according to random number table method. The patients in the control group were treated with bilateral uterine artery embolization combined with hysteroscopy negative pressure uterine clearance, while the patients in the study group were treated with pituitrin injection combined with hysteroscopy negative pressure uterine clearance. The operation duration, intraoperative bleeding volume, postoperative vaginal bleeding duration, hospitalization time, β-hCG recovery time, postoperative menstrual recovery time, menstrual recovery cycle and menstrual duration were counted, and the adverse reactions were observed. Results The amount of bleeding during uterine clearance in the study group[(23.67±3.47)mL] was significantly less than that in the control group[(34.81±6.95)mL], the duration of vaginal bleeding after operation[(5.84±1.62)d] and the length of hospitalization[(5.07±1.38)d] were significantly shorter than those in the control group[(9.36±2.49) d and(8.42±2.01) d, all P<0.001].The recovery time of menstruation in the study group[(37.96±3.85)d] were significantly shorter than those in the control group[(42.72±4.03)d, t=-8.825, P<0.001]. The incidence of the adverse reactions of the study group(1.11% and 0.00%) was significantly lower than that of the control group(8.89% and 6.67%, χ2=4.211, 4.310, P=0.040, 0.038). Conclusion Compared with bilateral uterine artery embolism, hysteroscopic negative pressure hysteroscopy after pituitrin injection can significantly reduce intraoperative bleeding, shorten the recovery period after operation, promote menstruation and ovulation recovery, reduce the incidence of adverse reactions after operation, which is safe and worthy of clinical application.
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