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| Study on the efficacy of high intensity focused ultrasound combined with postoperative uterine clearing in the treatment of placenta accreta |
| ZHANG Yuting1 LUO Xin2 MING Xue3 CAO Jie1 YANG Zhu4 ZHAO Chunquan2▲ |
1.Department of Obstetrics and Gynecology, University City Hospital Affiliated to Chongqing Medical University, Chongqing 401331, China;
2.Department of Gynecology, the First Hospital Affiliated to Chongqing Medical University, Chongqing 400016, China;
3.Department of Obstetrics and Gynecology, Suining Central Hospital, Sichuan Province, Suining 629000, China;
4.Department of Gynecology, the Second Hospital Affiliated to Chongqing Medical University, Chongqing 400010, China |
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Abstract Objective To study the effect of high intensity focused ultrasound (HIFU) combined with uterine clearing on placenta accreta and its complications. Methods From January 2016 to June 2018, in University City Hospital Affiliated to Chongqing Medical University and the First Hospital Affiliated to Chongqing Medical University, 60 patients with placenta accreta were selected, according to random number table method, they were divided into control group and observation group, with 30 cases in each group. The control group was treated with transuterine arterial methotrexate embolization combined with uterine clearing, and the observation group was treated with high intensity focused ultrasound combined with postoperative uterine clearing. The blood loss, postoperative blood loss and one-off uterine clearance success rate, the rate of hysterectomy, the incidence of postoperative complications, postoperative pain score, serum human chorionic gonadotropin β(β-HCG), hospitalization time, uterine recovery time, menstrual recovery time, immune function index in the two groups were compared. Results There was no significant difference in the success rate of one-off uterine clearing between the two groups (P > 0.05), but the amount of intraoperative and postoperative bleeding in the observation group was lower than that in the control group (P < 0.05). The hysterectomy rate and the total incidence of postoperative complications in the observation group were lower than those in the control group (P < 0.05). The postoperative pain score was lower than that in the control group (P < 0.05). After operation, the serum β-HCG in the observation group was lower than that in the control group (P < 0.05). The recovery time of serum β-HCG, hospitalization time, uterine recovery time and menstrual recovery time in the observation group were shorter than those in the control group (P < 0.05). The indexes of CD3+ and CD4+/CD8+ in the two groups were lower than those before operation (P < 0.05), but the immune function indexes in the observation group were higher than those in the control group (P < 0.05). Conclusion High intensity focused ultrasound combined with postoperative hysterectomy can effectively reduce the amount of bleeding, complications and hysterectomy of patients on the basis of ensuring the effect of hysterectomy, which is conducive to the reduction of postoperative pain and abnormal immune function, and the prompt recovery of serum betahcg, uterus and menstruation of patients.
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