Comparative Study On The Clinical Effect Of Abdominal Aortic Balloon Occlusion And Uterine Artery Embolization In The Treatment Of Cesarean Scar Pregnancy

ObjectiveBy comparing the clinical effects of abdominal aortic balloon occlusion and uterine artery embolization(UAE)in the treatment of type II cesarean section scar pregnancy(CSP),to explore the safety and efficacy of abdominal aortic balloon occlusion in the treatment of type II CSP and to provide more safe and effective treatment for type II CSP.MethodsA total of 90 patients with type II CSP treated in the second affiliated Hospital of Fujian Medical University from January 2017 to January 2020 were selected as subjects,and their clinical data were analyzed retrospectively.According to the method of interventional preconditioning,the patients were divided into two groups:(1)abdominal aortic balloon occlusion group(n=30),abdominal aortic balloon occlusion and ultrasonic monitoring uterine curettage immediately after operation,and(2)UAE group(n=60),uterine artery embolization before uterine debridement and ultrasonic monitoring uterine curettage 48 hours after operation.According to the complications and adverse reactions of interventional surgery,the recovery of clinical indexes after uterine curettage and the basic situation of hospitalization,the efficacy and safety of abdominal aortic balloon occlusion and uterine artery embolization in the treatment of type II CSP were compared.Results(1)Compared with the general data such as age,pregnancy,delivery,abortion,cesarean section,the number of years since the last cesarean section,the days of menopause,the diameter of pregnancy sac under ultrasound,the thickness of pregnancy sac to uterine serosa,preoperative hemoglobin and preoperative β-HCG,there was no significant difference between abdominal aorta balloon occlusion group and UAE group(P >0.05).(2)The amount of arterial bleeding and uterine bleeding in the abdominal aorta balloon occlusion group were lower than those in the UAE group,and the difference was statistically significant.(P<0.05).(3)The length of stay,the cost of intervention and the total cost of hospitalization(minus the cost of anesthesia)in the abdominal aorta balloon occlusion group were less than those in the UAE group(P<0.05).(4)The incidence of adverse reactions,the decrease of HCG on the first day after operation,the time needed to return to normal menstrual cycle and the incidence of decreased menstrual volume in the abdominal aorta balloon occlusion group were less than those in the UAE group(P<0.05).ConclusionsThe clinical effect of abdominal aortic balloon occlusion in the treatment of CSP is better than that of uterine artery embolization,with less postoperative complications,less uterine bleeding,cost saving and rapid recovery.