阴式手术在治疗剖宫产疤痕妊娠中的临床价值

发布时间：2018-03-15 08:16

本文选题：剖宫产疤痕妊娠　切入点：阴式手术　出处：《现代妇产科进展》2017年07期 　论文类型：期刊论文

【摘要】：目的:探讨阴式手术在治疗剖宫产疤痕妊娠(CSP)中的临床价值。方法:回顾分析2008年1月~2015年12月广西壮族自治区人民医院妇科收治的90例CSP患者的临床资料,其中43例行阴式手术,47例行腹腔镜手术治疗。结果:患者均顺利完成清除病灶和修复疤痕手术。阴式组和腹腔镜组的手术时间分别为(58.1±5.0)min、(61.7±7.3)min,两组比较差异无统计学意义(P0.05);术中出血量分别为(297.0±91.0)ml、(314.0±109.6)ml,差异有统计学意义(P0.05)。阴式手术均由高年资医师完成,与腹腔镜组(高年资39例,低年资8例)比较,差异有统计学意义(P0.05)。阴式组术前行子宫动脉栓塞术(UAE)14例,与非UAE病例的术中出血量比较,差异有统计学意义[(249.29±49.21)ml vs(299.31±71.01)ml,P=0.023]。两组均无手术并发症发生,两组的术后平均住院时间、血β-HCG恢复正常时间比较,差异无统计学意义(P0.05)。结论:阴式手术行病灶清除、修补疤痕治疗CSP可行、安全、有效,具有微创手术的优势,术者应具备良好的阴式手术技能,值得临床推广。
[Abstract]:Objective: to investigate the clinical value of vaginal operation in the treatment of cesarean scar pregnancy. Methods: the clinical data of 90 cases of CSP in gynecological department of Guangxi Zhuang Autonomous region people's Hospital from January 2008 to December 2015 were retrospectively analyzed. 43 cases underwent laparoscopic surgery and 47 cases underwent laparoscopic surgery. Results: all patients successfully completed debridement and scar repair. The operative time in the negative group and the laparoscopic group was 58.1 卤5.0 min and 61.7 卤7.3 min, respectively. There was no significant difference between the two groups. The blood loss during operation was 297.0 卤91.0ml / ml and 314.0 卤109.6ml / ml respectively, the difference was statistically significant (P 0.05). Compared with laparoscopic group (39 cases with high seniority and 8 cases with low seniority), the difference was statistically significant (P 0.05). 14 cases of uterine artery embolization were performed before operation in the negative group, and the amount of intraoperative bleeding was compared with that in the non UAE cases. The difference was statistically significant [249.29 卤49.21ml vs(299.31 卤71.01ml P0.023]. There were no postoperative complications in the two groups. There was no significant difference in the average postoperative hospitalization time and the recovery time of serum 尾 -HCG between the two groups (P 0.05). Conclusion: it is feasible for CSP to be treated by debridement and scar repair. It is safe, effective and has the advantage of minimally invasive surgery.
【作者单位】：广西壮族自治区人民医院妇科;
【分类号】：R713.8

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