摘要
目的分析腹腔镜下妊娠物切除联合宫腔镜探查对Ⅲ型剖宫产术后瘢痕妊娠(caeasrean scar pregnancy,CSP)患者子宫内膜容受性的影响。方法选取2020年1月至2022年1月湖州市中心医院收治的95例Ⅲ型CSP患者的临床资料,根据治疗方式不同分为对照组(阴式手术局部切除)47例与观察组(腹腔镜下妊娠物切除联合宫腔镜探查)48例。比较两组患者的术后指标、生理应激指标、子宫内膜容受性指标、子宫内膜血流及内膜回声分型。结果观察组患者的阴道流血、人绒毛膜促性腺激素降至正常、月经恢复正常时间短于对照组(P<0.05);并发症发生率低于对照组(2.08%vs.12.76%)(P<0.05);术后两组患者的皮质醇、C反应蛋白均升高,子宫内膜容积、内膜血管指数、血管血流指数均降低,观察组患者的各指标变化幅度大于对照组(P<0.05);治疗后,两组患者的子宫内膜血流、内膜回声分型比较差异有统计学意义(P<0.05),观察组患者的子宫内膜血流分型以Ⅲ型为主(52.08%),对照组以Ⅱ型为主(38.30%);观察组患者的子宫内膜回声以A型为主(54.17%),对照组以B型为主(40.43%)。结论腹腔镜下妊娠物切除联合宫腔镜探查治疗Ⅲ型CSP患者的效果确切,对子宫内膜容受性损伤小,有利于满足患者后期再孕需求。
Objective To analyze the effect of laparoscopic pregnancy object resection combined with hysteroscopy exploration on endometrial receptivity in patients with typeⅢcesarean scar pregnancy(CSP).Methods The clinical data of 95 patients with typeⅢCSP admitted to Huzhou Central Hospital from January 2020 to January 2022 were collected.According to different treatment methods,they were divided into control group(47 cases of vaginal surgical local resection)and observation group(48 cases of laparoscopic pregnancy material resection combined with hysteroscopy exploration).Compared with two groups of postoperative indicators,physiological stress indicators,endometrial receptivity indicators,endometrial blood flow and endometrial echo classification.Results The vaginal bleeding time,human chorionic gonadotropin drop to normal time,menstruation return to normal time in observation group were shorter than those in control group(P<0.05).The total incidence of complications in observation group was 2.08%,which was lower than 12.76%in control group(P<0.05).After operation,the levels of cortisol and C-reactive protein in two groups increased,endometrial volume,vascular index and vascular flow index values decreased,and the changes of each index in observation group were greater than those in control group(P<0.05).After treatment,there were differences in endometrial blood flow type and endometrial echo type between two groups(P<0.05).The endometrial echo was mainly typeⅢin observation group(52.08%)and typeⅡin control group(38.30%).The endometrial echo of observation group was mainly type A(54.17%),while control group was mainly type B(40.43%).Conclusion Laparoscopic pregnancy object resection combined with hysteroscopy exploration is effective in the treatment of typeⅢCSP patients,with less damage to endometrial receptivity,which is conducive to the needs of patients for later pregnancy.
作者
徐伟
丁欢
XU Wei;DING Huan(Department of Respiratory and Critical Care Medicine,Huzhou Central Hospital,Huzhou Normal University Affiliated Central Hospital,Huzhou 313000,Zhejiang,China)
出处
《中国现代医生》
2024年第21期51-54,共4页
China Modern Doctor
基金
湖州市科学技术局项目(2020GYB93)。
关键词
腹腔镜下妊娠物切除
宫腔镜探查
剖宫产
瘢痕妊娠
子宫内膜容受性
Laparoscopic pregnancy object resection
Hysteroscopy exploration
Cesarean section
Scar Endometrial receptivity
