外生型剖宫产瘢痕妊娠三种治疗方法的对比研究

发布时间：2018-03-23 18:52

本文选题：剖宫产瘢痕妊娠　切入点：经阴式手术　出处：《实用妇产科杂志》2015年04期

【摘要】：目的:对比分析外生型剖宫产瘢痕妊娠(CSP)三种治疗方法的临床疗效。方法:回顾性分析2010年1月至2014年8月在四川省人民医院诊治的59例外生型CSP患者的临床资料。按不同的手术方法分为:经阴道子宫下段妊娠病灶切除术组(经阴道组)19例;子宫动脉栓塞术联合宫腹腔镜治疗组(栓塞组)22例,腹腔镜下妊娠病灶切除术组(腹腔镜组)18例。观察3组患者术中出血量、手术时间、术后疼痛、术后肛门排气时间、住院时间、住院费用、血β-HCG降至正常时间、术后月经恢复时间。结果:经阴道组和栓塞组手术均顺利完成,无中转开腹,腹腔镜组有2例中转开腹。腹腔镜组患者术中出血量多于经阴道组和栓塞组(P0.05),而经阴道组与栓塞组比较,差异无统计学意义(P0.05)。经阴道组手术时间和术后肛门排气时间短于栓塞组和腹腔镜组(P0.05),而腹腔镜组与栓塞组间比较,差异无统计学意义(P0.05)。栓塞组与经阴道组及腹腔镜组比较,术后Ⅲ级疼痛发生率高,住院时间、月经恢复时间长,住院费用高,差异均有统计学意义(P0.05);而腹腔镜组与经阴道组比较,差异无统计学意义(P0.05)。3组血β-HCG下降至正常时间比较,差异无统计学意义(P0.05)。结论:三种方式均可用于治疗外生型CSP,经阴道子宫下段妊娠病灶切除术优于子宫动脉栓塞联合宫腹腔镜治疗和腹腔镜下妊娠病灶切除术。
[Abstract]:Objective: to compare and analyze the clinical efficacy of three methods for treatment of ectogenic cesarean scar pregnancy. Methods: the clinical data of 59 patients with CSP in Sichuan Provincial people's Hospital from January 2010 to August 2014 were retrospectively analyzed. Materials. According to different surgical methods, they were divided into two groups: transvaginal hysterectomy group (19 cases); Uterine artery embolization combined with uterine laparoscopy (22 cases in embolization group and 18 cases in laparoscopy group). Time of hospitalization, cost of hospitalization, blood 尾 -HCG decreased to normal time, menstrual recovery time after operation. Results: the transvaginal group and embolization group were successfully completed, no conversion to laparotomy, In the laparoscopic group, the amount of intraoperative bleeding was higher than that in the transvaginal group and the embolization group (P 0.05), but the transvaginal group was compared with the embolization group. There was no significant difference between the two groups (P 0.05). The operation time and the postoperative anal exhaust time in the transvaginal group were shorter than those in the embolization group and the laparoscopic group, but there was no significant difference between the laparoscopy group and the embolization group. There was no significant difference between the embolization group and the transvaginal group and the laparoscopic group, and there was no significant difference between the transvaginal group and the laparoscopic group. The incidence of postoperative pain was higher, hospitalization time was longer, menstrual recovery time was longer, hospitalization cost was higher, and the difference was statistically significant (P 0.05), but there was no significant difference between laparoscopy group and transvaginal group in the decrease of serum 尾 -HCG to normal time. Conclusion: all three methods can be used in the treatment of exogenous CSP. Transvaginal subuterine pregnancy focus resection is superior to uterine artery embolization combined with uterine laparoscopy and laparoscopic pregnancy focus resection.
【作者单位】：四川省人民医院;
【分类号】：R714.22

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