腹腔镜双侧子宫动脉阻断联合宫腔镜妊娠病灶清除治疗剖宫产瘢痕妊娠

发布时间：2019-04-19 04:52

【摘要】：目的观察腹腔镜双侧子宫动脉阻断联合宫腔镜妊娠病灶清除治疗剖宫产瘢痕妊娠的临床疗效。方法选取本院2013年1月~2015年2月收治的60例CSP患者作为研究对象,将60例CSP患者以随机数表法平均分成观察组(腹腔镜双侧子宫动脉阻断+宫腔镜妊娠病灶清除)与对照组(双侧子宫动脉栓塞术+B超监测清宫术)各30例。观察两组患者手术资料(术中出血量、住院时间、住院费用);术后血清h CG恢复正常时间、1次治愈率、月经复潮时间、术后2年内再次妊娠情况与妊娠结局、再次CSP情况(出院后);术后并发症情况。结果观察组患者术中出血量、住院时间及住院费用均明显低于对照组(P0.05),但两组患者手术时间对比无显著差异(P0.05)。两组患者术后血h CG恢复正常时间、1次治愈率及月经复潮时间对比无显著差异(P0.05)。两组患者再次妊娠且顺利生产率与再次CSP率对比无显著差异(P0.05)。观察组患者并发症出现率明显低于对照组(P0.05)。讨论腹腔镜双侧子宫动脉阻断联合宫腔镜妊娠病灶清除应用于剖宫产瘢痕妊娠临床治疗中,可有效减少患者术中出血量,缩短住院时间,减少住院费用,且并发症较少、安全性较高,值得临床推广。
[Abstract]:Objective to observe the clinical effect of laparoscopic bilateral uterine artery occlusion combined with hysteroscopic focus clearance in the treatment of cesarean scar pregnancy. Methods 60 patients with CSP from January 2013 to February 2015 in our hospital were selected as subjects. Sixty patients with CSP were randomly divided into two groups: observation group (laparoscopic bilateral uterine artery occlusion hysteroscopic focus clearing) and control group (bilateral uterine artery embolization B-ultrasound monitoring uterine debridement). The operative data (volume of intraoperative bleeding, length of hospital stay, hospitalization cost) were observed in the two groups. After operation, the serum h-CG returned to normal time, the cure rate was one time, the menstrual regurgitation time, the second pregnancy within 2 years after the operation and the pregnancy outcome, the re-CSP condition (after discharge), and the postoperative complications. Results the bleeding volume, hospitalization time and hospitalization cost in the observation group were significantly lower than those in the control group (P0.05), but there was no significant difference in the operative time between the two groups (P0.05). There was no significant difference in the recovery time of h-CG, cure rate and menorrhagia time between the two groups (P0.05). There was no significant difference between repregnancy rate and CSP rate between the two groups (P0.05). The incidence of complications in the observation group was significantly lower than that in the control group (P0.05). To discuss the application of laparoscopic bilateral uterine artery occlusion combined with hysteroscopic focus removal in the clinical treatment of cesarean scar pregnancy, which can effectively reduce the amount of bleeding during operation, shorten the length of hospital stay, and reduce the cost of hospitalization, with fewer complications. It is safe and worthy of clinical popularization.
【作者单位】：郑州市妇幼保健院产科
【分类号】：R713.8

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