| Objective:The present study was aimed to investigate the application value and indications of uterine artery embolization for cesarean scar ectopic pregnancy,and to compare the clinical effect of uterine artery embolization on different types of CSP patients,and thus,to provide new ideas and theoretical basis in the management of CSP.Methods:Clinical data of 178 CSP patients admitted during June 2016 to November 2017 was retrospectively analyzed,and the patients were divided into group A and group B according to different treatment methods.The treatment plan of Group A was took operative combine with uterine artery embolization after 24-48 hours.And group B patients was to directly perform different appropriate surgical treatments in our institution.The difference in intraoperative blood loss,postoperative hemoglobin drop,operative time,days of hospitalization,and treatment cost were compared between the two groups of patients.The postoperative secondary treatment rates and postoperative complications also were compared between the two groups.At the same time,the differences between the above indexes in patients with type I,type II and type III CSP in the two groups were compared.Results:The operation time in group A(65.43±32.94)was greater than that in group B(55.03±30.10)(P<0.05);the decrease of hemoglobin in group A(15.33±8.26)was less than that in group B(18.11±11.69)(P<0.05);The hospitalization costs(23908.48±4931.34)in the group were significantly higher than those in the group B(13055.68±5398.30)(P<0.05),and the differences were statistically significant.There was no significant difference in the amount of intraoperative blood loss and hospital stay between A and B groups(P>0.05).The amount of intraoperative blood loss(102.35±101.95)was higher in patients with CSP I(102.35±101.95)than in patients who did not receive UAE(59.72±50.15)(P<0.05);the length of hospital stay(6.41±2.12)who received UAE was longer than in patients who did not receive UAE.The treatment group(5.00±1.62)(P<0.05);The hospitalization cost of UAE treatment(221130.26±3917.85)was more than the UAE treatment group(10875.65±3739.09)(P<0.05),the operation time and the decrease of the postoperative hemoglobin.There was no significant difference between the two groups(P>0.05).The intraoperative blood loss of patients with CSP II treated with UAE(60.53±54.46)was significantly lower than that without UAE treatment(129.00±104.37)(P<0.05);the decrease of postoperative hemoglobin in patients treated with UAE(15.42±9.26).Significantly less than UAE-untreated group(22.03±15.05)(P<0.05);UAE-treated patients(22698.73±4565.52)had more hospitalization costs than those who did not receive UAE(15181.77±5243.34)(P<0.05).There was no significant difference between the two groups in the operation time and length of stay of CSP II patients(P>0.05).The intraoperative blood loss of CSP III patients treated with UAE(117.14±86.28)was significantly lower than that without UAE(298.00±374.22)(P<0.05);the decrease of postoperative hemoglobin in patients treated with UAE(11.07±11.5).Significantly less than UAE treatment group(20.20±11.65)(P<0.05);Hospitalization costs of patients receiving UAE treatment(26629.92±4979.57)were more than those of UAE treatment group(18667.60±7485.36)(P<0.05).There was no significant difference in the operation time and length of stay between patients with CSP III(P>0.05).A total of 83 patients in group A had a successful treatment rate of 100%(83/83).A total of 95 patients in group B had a successful treatment rate of 91.58%(87/95).The success rate of primary treatment in group A was significantly higher than that in group B,P<0.05,and the difference was statistically significant.There was no significant difference in postoperative treatment rates between patients with CSP I and II in both groups A and B(P>0.05).There was a difference in postoperative treatment rates between patients with CSP III in groups A and B.Statisticalsignificance(P<0.05),in which the secondary treatment rate in group A was significantly lower than that in group B.The postoperative fever in group A(28/83,33.73%)was significantly higher than that in group B(9/95,9.47%),and the difference was statistically significant(P<0.05).Conclusion:CSP I patients can directly surgical treatment to avoid postoperative complications caused by UAE,reduce the economic burden on patients.Patients with CSP II and CSP III have higher risk of bleeding because of the higher risk of bleeding and the scars are very thin and the operation is more difficult.Combined UAE can reduce the amount of blood loss during CSP and improve the prognosis of patients. |
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