78例内生型剖宫产术后瘢痕妊娠两种术式的比较分析

发布时间：2018-04-03 09:44

本文选题：剖宫产术后子宫瘢痕妊娠　切入点：清宫术　出处：《广西医科大学》2017年硕士论文

【摘要】：目的:探讨内生型剖宫产术后瘢痕妊娠(cesarean scar pregnancy,CSP)的临床特点,比较清宫术和切开取胚术两种方法治疗内生型CSP的临床疗效及结局,为临床治疗内生型子宫瘢痕妊娠提供有价值的参考。方法:回顾性分析广西医科大学第一附属医院妇产科2012年7月-2016年10月收治的78例内生型CSP患者的临床资料,根据治疗方法不同,将内生型CSP患者分为A组(清宫术组)47例和B组(切开取胚术组)31例,应用spss22.0统计软件进行数据分析处理,比较A、B组的临床一般资料、术中出血量、手术持续时间、住院费用、住院时间及术后随访情况等相关指标综合评价两种治疗方法的差异。结果:所有患者入院均经阴道彩色多普勒超声检查诊断为CSP,其中有10例(12.2%)术前为明确孕囊与切口及周围组织关系而通过MRI(Magnetic resonance imaging)进一步检查,所有患者术中肉眼可见绒毛或术后病理可见绒毛组织,且均符合瘢痕妊娠。内生型A、B两组患者的停经时间、年龄、孕产次、人流次数、入院时血人绒毛膜促性腺激素(Human Chorionic Gonadotropin,HCG)水平、剖宫产次数、距上次剖宫产的间隔时间、病灶最大直径大小及病灶与子宫浆膜层的距离差异无统计学意义(P0.05)。A组术中出血量、手术持续时间及住院费用均少于B组(均P0.05),而两组的住院时间、血β-HCG值降至正常的时间及术后月经恢复正常的时间的差异无统计学意义(P0.05)。内生型A、B两组治疗方法的成功率比较无统计学差异(χ2=0.009,P=0.925)。结论:在内生型CSP治疗上,B超引导下清宫术与切开取胚术相比,可能更加安全、简单、经济。
[Abstract]:Objective: To investigate the endogenous type of cesarean scar pregnancy (cesarean scar, pregnancy, CSP) the clinical characteristics, clinical efficacy and outcomes of uterine curettage and embryo surgery incision of two methods in the treatment of endogenous CSP, for the treatment of endogenous type of uterine scar pregnancy to provide valuable reference. Methods: a review analysis of the clinical data of 78 cases of endogenous CSP patients in Department of Obstetrics and Gynecology the First Affiliated Hospital of Guangxi Medical University in July 2012 -2016 year in October, according to the different treatment methods, the endogenous CSP were divided into group A (curettage group) 47 cases and group B (incision embryo surgery group) 31 cases, using spss22.0 statistical software analyze the data of A, the general clinical data of B group, the amount of bleeding, hospitalization expenses, duration of operation, the difference between the two treatment methods of comprehensive evaluation indexes of hospitalization time and follow-up after operation. Results: all patients were treated by Transvaginal color Doppler ultrasound for the diagnosis of CSP, of which 10 cases (12.2%) before operation to clear the gestational sac and incision and surrounding tissues and by MRI (Magnetic resonance imaging) for further examination, all patients in the visible villi or histopathology showed the villi, and are consistent with the endogenous A scar pregnancy. B, the two groups of patients with age, menopause, pregnancy, abortion, admission blood human chorionic gonadotropin (Human Chorionic, Gonadotropin, HCG) level, the number of cesarean section, cesarean section from the last interval, there was no significant difference in maximum diameter distance lesions and lesions with uterine serosa the amount of bleeding (P0.05) in.A group, operation time and hospitalization costs were less than group B (P0.05), while the two group hospitalization time, the difference of serum beta -HCG decreased to normal time and postoperative menstrual recovery time without the There was no significant difference in the success rate between the two groups of endogenous A and B (chi 2=0.009, P=0.925). Conclusion: compared with the embryo cutting operation under the guidance of ultrasound, the P0.05 guided ultrasound guided operation is safer, simpler and more economical.

【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R713.8

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