摘要
目的:探讨子宫瘢痕处妊娠的临床处理方式及腹腔镜监护下吸宫术治疗子宫瘢痕处妊娠的应用价值。方法选择2006年1月~2012年12月共收治的46例剖宫产术后子宫瘢痕妊娠患者,其中45例进行回顾性分析既往治疗方案并分阶段采取不同治疗方式进行治疗。对比分析几种治疗方式之间治愈率、阴道流血时间、β-HCG下降情况、住院时间及费用。结果采用单纯药物治疗的14例患者,成功率70%。采取药物加吸宫术17例患者中成功率83%。采取腹腔镜监护下吸宫术联合药物治疗组14例患者均取得成功,成功率100%。三组治愈率差异有统计学意义(P<0.05)。46例患者中另1例因大出血急症入院,急症开腹手术治疗,未参与对照研究。而住院时间腹腔镜监护下吸宫术联合药物治疗组也明显短于其他两组,差异有统计学意义(P<0.05)。β-HCG下降时间腹腔镜监护下吸宫术联合药物治疗组和药物治疗加吸宫术组差异无统计学意义(P>0.05),但明显短于单纯药物治疗组,差异有统计学意义(P<0.05)。住院费用腹腔镜监护下吸宫术联合药物治疗组和药物治疗加吸宫术组两组间差异无统计学意义(P>0.05),但高于单纯药物治疗组(P<0.05)。结论单纯药物治疗子宫瘢痕处妊娠方法简单易行,费用低,但相对成功率低、住院时间长,适用于基层医院。药物治疗后吸宫术治疗子宫瘢痕处妊娠成功率略高,但部分患者治疗失败后大出血需紧急手术,风险高,进一步治疗后花费也较高。腹腔镜监护下吸宫术治疗子宫瘢痕处妊娠在费用相差不大的情况下:治愈率高,住院时间短、安全、可靠。性价比高符合卫生经济学,值得临床推广应用。
Objective To investigate the clinical measure of pregnancy with uterine scar and the application value of laparoscopic monitoring curettage for treating the pregnancy with uterine scar. Methods 46 cases of pregnancy patients with cesarean scar in our hospital from January 2006 to December 2012 were selected, of which 45 cases were analyzed retrospectively and taken different stages for treatment. several treatment cure rate, vaginal bleeding,β-HCG drop cases, hospitalization time and costs were compared and analyzed among the several therapy measures. Results 14 patients received drug therapy only, the success rate was 70%. 17 patients further received curettage, the success rate was 83%. 14 patients received laparoscopic monitoring curettage combined with drug therapy were all successful, the success rate was 100%. The cure rate of the three groups was statistically significant (P〈0.05). Another case in 46 patients with bleeding accident and emergency admissions, received accident and emergency laparotomy, did not participate in controlled study. The hospital stay time of laparoscopic monitoring curettage combined with drug therapy group was significantly shorter than other two groups, the difference was statistically significant (P〈0.05).β-HCG fall time between laparoscopic monitoring curettage combined with drug therapy group and curettage with drug therapy group had no significant difference (P〉0.05), while it was significantly shorter than simple drug group, the difference was statistically significant (P〈0.05). Hospital costs between laparoscopic monitoring curettage combined with drug therapy group and curettage with drug therapy group was not statistically significant (P〉0.05), while was higher than simple drug group (P〈0.05). Conclusion The simple drug treatment of pregnancy with uterine scar is easy, low cost, but relatively low success rate and long hospital stay, which is applicable to the primary hospital. The success rate of curettage after medication treatment
出处
《中国医药科学》
2015年第6期67-71,共5页
China Medicine And Pharmacy
关键词
异位妊娠
子宫瘢痕
腹腔镜监护
吸宫术
药物治疗
Ectopic pregnancy
Uterine scar
Laparoscopic monitoring
Curettage
Medication