【摘要】 目的:探讨不同手术方式治疗剖宫产瘢痕妊娠的效果。方法:临床纳入笔者所在医院2012-2017年收治的208例确诊为剖宫产瘢痕妊娠患者作为研究对象,根据不同手术方式将入选者分为A组(超声监视下清宫术)、B组(宫腔镜瘢痕妊娠组织清除术)、C组(腹腔镜瘢痕组织清除术+子宫下段瘢痕修补术)、D组(经阴道瘢组织清除术+子宫下段瘢痕修补术),各52例。将四组手术相关指标及术后并发症情况进行对比。结果:四组患者在手术时间、术中出血量、血β-hCG降至正常时间、住院时间、住院费用等指标上对比差异均有统计学意义(P<0.05),其中B组术式可更明显减少术中出血量、缩短血β-hCG降至正常时间,且住院费用相对较低。四组患者术后并发症发生率分别为5.77%、1.92%、3.85%、5.77%,其中B组术后并发症发生率最低,其次是C组、A组、D组,但四组间对比差异无统计学意义(P>0.05)。结论:对剖宫产瘢痕妊娠患者而言,宫腔镜瘢痕妊娠组织清除术是一种理想治疗方式,可有效减少术中出血量,促使血β-hCG降至正常水平,减少患者住院费用,临床上应根据患者具体情况选择合适手术方式,保障治疗效果。更多还原

【Abstract】 Objective:To explore the effect of different surgical methods in the treatment of cesarean section scar pregnancy.Method:In this hospital from 2012 to 2017,208 cases of clinical diagnosis of cesarean scar pregnancy patients were selected as the research object.According to different operation,all patients were divided into group A(under ultrasound monitoring) and group B(removal of hysteroscopy scar pregnancy group),group C(laparoscopic surgical scar tissue to remove +lower uterine segment scar repair),group D(transvaginal removal of scar tissue+lower uterine segment scar repair),each of 52 cases.Four groups of operative indicators and postoperative complications were compared.Result:There were statistically significant differences among the four groups in terms of operation time intraoperative blood loss,and blood-hCG reduced to normal time,length of hospital stay,and hospitalization expense(P<0.05).Among which the surgical method of group B could significantly reduce the intraoperative blood loss,shorten the hypoxic-hCG to normal time,and the hospitalization cost was relatively low.The incidence of postoperative complications in the four groups was 5.77%,1.92%,3.85% and 5.77%,respectively.The incidence of postoperative complications in group B was the lowest,followed by group C,A and D,but the difference among the four groups was not statistically significant(P>0.05).Conclusion:For patients with cesarean scar pregnancy,hysteroscopic scar pregnancy tissue removal is an ideal treatment method,which can effectively reduce intraoperative blood loss,promote the reduction of blood chondro-hCG to normal levels,and reduce the hospitalization costs of patients.Clinically,appropriate surgical methods should be selected according to the specific conditions of patients to guarantee the treatment effect.更多还原