【摘 要】
：
目的 评估微波消融(microwave ablation,MWA)和射频消融(radiofrequency ablation,RFA)减胎术对复杂性单绒毛膜妊娠的治疗效果.方法 本研究收集2012年1月1日—2018年12月31日在北京大学第三医院产科进行MWA和RFA减胎术治疗的复杂性单绒毛膜妊娠孕妇的临床资料,包括术前资料、手术资料和妊娠结局.比较MWA和RFA减胎术的手术过程和妊娠结局.结果 181例减胎孕妇中,132例行MWA,49例行RFA.两组手术过程比较显示,MWA组比RFA组消融时长短(6
【机 构】
：
100191 ,北京大学公共卫生学院妇幼卫生学系;100191 ,北京大学公共卫生学院妇幼卫生学系;国家卫生健康委员会生育健康重点实验室;北京大学第三医院妇产科
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目的 评估微波消融(microwave ablation,MWA)和射频消融(radiofrequency ablation,RFA)减胎术对复杂性单绒毛膜妊娠的治疗效果.方法 本研究收集2012年1月1日—2018年12月31日在北京大学第三医院产科进行MWA和RFA减胎术治疗的复杂性单绒毛膜妊娠孕妇的临床资料,包括术前资料、手术资料和妊娠结局.比较MWA和RFA减胎术的手术过程和妊娠结局.结果 181例减胎孕妇中,132例行MWA,49例行RFA.两组手术过程比较显示,MWA组比RFA组消融时长短(6.0 min和7.5 min,P=0.010)、消融功率低(35.0 W和50.0 W,P<0.001).妊娠结局比较显示,RFA组和MWA组的保留胎儿存活情况差异无统计学意义(57.7％和66.2％),但在胎死宫内率(42.0％和23.4％,P=0.011)、新生儿出生低体重率(55.6％和31.1％,P=0.021)以及新生儿转重症监护室率(60.0％和32.2％,P=0.011)上,RFA组要高于MWA组.结论 MWA作为一种新的减胎手术方式,与RFA减胎术术后的胎儿存活率没有统计学差异,但保留胎儿胎死宫内率和出生低体重率更低,并且手术消融时长更短、消融功率更低,手术更为便捷,在临床应用中更有优势.
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