摘要
目的:分析宫腔镜瘢痕妊娠胚物清除/切除术治疗剖宫产瘢痕妊娠(CSP)患者的临床资料,探讨影响术中出血量的相关危险因素及选择适宜的手术治疗方式。方法:回顾性分析2016年6月-2018年6月在本院采用宫腔镜下瘢痕妊娠胚物清除/切除术联合或不联合宫腔球囊压迫治疗CSP患者280例临床资料。结果:①宫腔镜手术中应用宫腔球囊压迫治疗者59例(21.1%),术后血β-hCG恢复正常时间5~56(24.5±8.9)d,术后月经恢复时间28~70(37.8±6.6)d。②术中出血量与孕囊大小、停经天数、术前血β-hCG值、术中子宫瘢痕憩室大小、血流情况有明显相关性(P<0.05);孕囊大小、血流情况、术前血β-hCG值是影响术中出血量的独立性危险因素。结论:应用宫腔镜下瘢痕妊娠胚物清除/切除术联合或不联合宫腔球囊压迫治疗I型及II型剖宫产瘢痕妊娠临床效果可靠;②停经时间长、孕囊大、血流丰富及术前血β-hCG高是CSP患者术中发生大出血的主要危险因素且宫腔镜术中放置宫腔球囊几率高。
Objective:To analyze the clinical data of hysteroscopic intrauterine scar pregnancy embryo removal or resection for treating 280 women with early cesarean scar pregnancy(CSP).Methods:The clinical data of 280 patients with CSP who experienced hysteroscopic intrauterine scar pregnancy embryo removal or resection combined with or without intrauterine balloon compression from March 2016 to June 2018 were analyzed retrospectively.Results:59(21.1%)patients were treated by hysteroscopic intrauterine scar pregnancy embryo removal or resection combined with intrauterine balloon compression,and their time of bloodβ-hCG returned to normal after operation was 5-56(24.5±8.9)days,and the time of postoperative menstrual recovery was 28-70(37.8±6.6)days.There was significant correlation between preoperative blood loss and the lesion size,menolipsis time,preoperative blood HCG level,or the size and blood flow situation of lesion(P<0.05).The lesion size,blood flow by ultrasound,and preoperative blood HCG value were the independent risk factors of intraoperative blood loss.Conclusion:The hysteroscopic intrauterine scar pregnancy embryo removal or resection combined with or without intrauterine balloon compression for treating patients with type I and type II CSP is feasible.Long time of menolipsis,large lesion,abundant blood flow of lesion by ultrasound,and high level of preoperative blood HCG are the major risk factors of intraoperative blood loss and of the intrauterine balloon compression used during operation.
作者
胡乔飞
陈素文
李长东
罗岚蓉
李坚
HU Qiaofei;CHEN Suwen;LI Changdong;LUO Lanrong;LI Jian(Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026)
出处
《中国计划生育学杂志》
2020年第6期931-934,共4页
Chinese Journal of Family Planning
基金
北京市医院管理局临床医学发展专项经费资助(ZYLX201830)。
