摘要
目的:探究阴式病灶清除术联合子宫瘢痕修补术治疗Ⅱ、Ⅲ型剖宫产子宫瘢痕妊娠(CSP)的效果。方法:回顾性分析2016年1月-2022年10月江苏省射阳县人民医院妇产科收治的30例Ⅱ、Ⅲ型CSP患者的临床资料,根据患者的手术方法分为观察组与对照组,各15例。对照组采用腹腔镜病灶清除术联合子宫瘢痕修补术治疗,观察组采用阴式病灶清除术联合子宫瘢痕修补术治疗。比较两组手术时间、术中出血量、并发症发生情况、阴道出血时间、血清β-人绒毛膜促性腺激素(β-HCG)恢复正常时间、月经恢复时间、住院时间。结果:观察组手术时间短于对照组,术中出血量少于对照组,差异有统计学意义(P=0.000)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。两组阴道出血时间、血β-HCG恢复正常时间、月经恢复时间比较,差异均无统计学意义(P>0.05)。观察组住院时间短于对照组,差异有统计学意义(P=0.000)。结论:对于Ⅱ、Ⅲ型CSP患者采用阴式病灶清除术联合子宫瘢痕修补术的效果显著,手术创伤小,术后恢复快,但阴式手术也有缺陷,临床医师在术前应仔细检查,结合患者的病情和意愿合理选择手术方式,促进患者术后早日康复。
Objective:To explore the effect of transvaginal debridement and uterine scar repair surgery in treatment of Types Ⅱ and Ⅲ cesarean scar pregnancy(CSP).Methods:Clinical data of 30 patients with Types Ⅱ and Ⅲ CSP who admitted to the Department of Obstetrics and Gynecology of Sheyang County People’s Hospital of Jiangsu Province from January 2016 to October 2022 were retrospectively analyzed.The patients were divided into observation group and control group according to the surgical methods,with15 cases in each group.The control group was treated by laparoscopic debridement combined with uterine scar repair surgery,and the observation group was treated by transvaginal debridement combined with uterine scar repair surgery.The operation time,intraoperative blood loss,complications,vaginal bleeding time,time of serum human chorionic gonadotropin β subunit(β-HCG)returning to normal level,menstrual recovery time,and length of hospital stay were compared between the two groups.Results:The operation time in the observation group was shorter than that in the control group,and the intraoperative blood loss in the observation group was less than that in the control group,and the difference was statistically significant(P=0.000).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).There were no significant differences in vaginal bleeding time,time of blood β-hCG returning to normal level and menstrual recovery time between the two groups(P>0.05).The length of hospital stay in the observation group was shorter than that in the control group,and the difference was statistically significant(P=0.000).Conclusion:In the patients with Types Ⅱ and Ⅲ cesarean scar pregnancy,the effect of transvaginal debridement and uterine scar repair surgery is significant,with small surgical trauma and rapid postoperative recovery.However,there are also some defects in transvaginal surgery.Clinicians should conduct preoperative examination carefully,reasonably choose the s
作者
陈娟
Chen Juan(Department of Obstetrics and Gynecology,Sheyang County People's Hospital,Yancheng 224300,Jiangsu Province,China)
出处
《中国社区医师》
2023年第2期18-20,共3页
Chinese Community Doctors
