摘要
目的:探讨不同手术方式治疗Ⅱ型剖宫产瘢痕部位妊娠(CSP)的临床效果。方法:回顾性分析重庆市妇幼保健院2016年4月至2019年5月收治的216例Ⅱ型CSP患者,根据手术方式不同分为3组:A组为口服米非司酮+超声引导下行清宫术的患者,共83例;B组为经阴道子宫瘢痕处妊娠物清除术+子宫修补术的患者,共98例;C组为宫腔镜下妊娠物电切术的患者,共35例。比较分析3组患者术前、术中、术后临床资料情况。结果:3组患者年龄、停经天数、妊娠次数、剖宫产次数、距前次剖宫产时间、妊娠囊平均直径、瘢痕厚度、术前血β-人绒毛膜促性腺激素(β-hCG)、术后血β-hCG降至正常时间及月经恢复时间比较差异均无统计学意义(P>0.05)。3组手术时间分别为16.71±3.71分钟、40.20±15.26分钟、34.57±11.21分钟,3组间比较差异均有统计学意义(P<0.05)。B组手术成功率(98.0%)和C组手术成功率(94.3%)高于A组(89.2%),差异有统计学意义(P>0.05)。B组术中出血量(67.14±67.07 ml)多于A组(46.22±65.32 ml)和C组(32.85±24.56 ml),住院费用(6728.96±1236.46元)高于A组(4548.29±1298.03元)和C组(5076.06±876.30元),差异均有统计学意义(P<0.05)。结论:宫腔镜下妊娠物电切术及经阴道子宫瘢痕处妊娠物清除术+子宫修补术治疗Ⅱ型CSP均有较好的临床疗效。
Objective:To investigate the clinical effects of three different treatments in typeⅡcesarean scar pregnancy(CSP).Methods:All typeⅡcesarean scar pregnancy patients who accepted treatment in our hospital from April 2016 to May 2019 were retrospectively analyzed.216 patients were enrolled in our study and they were divided into based on the treatments they had.83 patients were divided into group A and they had Mifepristone and ultrasound guided curettage.In group B,98 patients underwent removal of ectopic pregnancy tissue and repair of uterine through vagina.In group C were 35 patients who had hysteroscopic curettage.Preoperative,intraoperative and postoperative clinical information of the three groups were collected and compared.Results:There were no significant differences in age,gestational days,number of pregnancies,number of cesarean sections,time intervalfrom the last cesarean section,average diameter of pregnancy sac,cesarean scar thickness,preoperative serumβ-hCG,time period for serumβ-hCG to decrease to normal after surgery and menstruation resuming(P>0.05).The operative time of the three groups were 16.71±3.71 min,40.20±15.26 min,34.57±11.21 min,the differences were statistically different(P<0.05).The success rate in group B(98.0%)and group C(94.3%)was higher than that of group A(89.2%),the difference was statistically different(P<0.05).The blood loss in group B(67.14±67.07 ml)was more than that in group A(46.22±65.32 ml)and in group C(32.85±24.56 ml).The average hospitalization expense in group B(6728.96±1236.46 yuan)was higher than that in group A(4548.29±1298.03 yuan)and in group C(5076.06±876.30 yuan),the differences were statistically different(P<0.05).Conclusions:The treatment of hysteroscopic curettage,as well as removal of ectopic pregnancy tissue and repair of uterine through vaginashow good clinical effects for typeⅡCSP.
作者
申丽媛
池余刚
刘宝
梁碧秀
SHEN Liyuan;CHI Yugang;LIU Bao(Department of Gynecology,Chongqing Health Center for Women and Children,Chongqing 400021,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2020年第7期532-535,共4页
Journal of Practical Obstetrics and Gynecology
