经阴道子宫下段切开取胚与子宫动脉栓塞术治疗剖宫产瘢痕妊娠的比较性研究  

A Comparative Study of Transvaginal Removal of Ectopic Pregnancy Tissue and Uterine Artery Embolization in the Treatment of Caesarean Scar Pregnancy

作　　者：单莉莉[1] 乐爱文[1] 肖天慧[1] 卓蓉[1] 朱婷 王中海[1] 

机构地区：[1]广东医学院附属南山医院妇科,深圳518052 [2]广东医学院附属南山医院超声科,深圳518052

出　　处：《中国微创外科杂志》2013年第7期611-613,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨经阴道前穹隆子宫下段切开取胚术和子宫动脉栓塞术对治疗剖宫产瘢痕妊娠的临床价值。方法2010年1月～2012年2月,在我院确诊的38例剖宫产瘢痕妊娠中,21例行子宫动脉化疗栓塞术+清宫术,17例行经阴道子宫下段切开取胚并修补子宫缺陷手术。比较2种术式的术中出血量、术后血hCG降至正常的时间、住院时间、住院费用。结果 2种术式术后血hCG下降至正常的时间差异无显著性(P>0.05),经阴道子宫下段切开取胚术的术中出血更少[(28.8±7.4)ml vs.(48.6±38.2)ml,t=-2.097,P=0.043],总住院时间更短[(6.2±1.5)d vs.(9.0±1.4)d,t=-6.012,P=0.000],住院费用更少[(7779.1±343.0)元vs.(13 299.6±712.2)元,t=-31.318,P=0.000]。结论经阴道子宫下段切开取胚并修补子宫缺陷手术是治疗剖宫产瘢痕妊娠的一种安全、有效、微创、经济的手术方式。Objective To study the clinical value of transvaginal removal of ectopic pregnancy tissue and uterine artery embolization in the treatment of caesarean scar pregnancy（CSP）.Methods Of the 38 cases of CSP,21 underwent uterine artery embolization and complete curettage of uterine cavity,while 17 patients underwent transvaginal removal of ectopic pregnancy tissue with repair of the uterine defect from January 2010 to February 2012.Intra-operative blood loss,time required for blood hCG returning to normal,hospital stay and cost were compared between the two groups.Results No significant difference could be found in the time required for blood hCG dropping to normal（P〈0.05）.Transvaginal removal of ectopic pregnancy tissue had less blood loss [（28.8±7.4）ml vs.（48.6±38.2）ml,t=-2.097,P=0.043],shorter hospital stay [（6.2±1.5）d vs.（9.0±1.4）d,t=-6.012,P=0.000] and less hospital cost [（7779.1±343.0）RMB vs.（13 299.6±712.2）RMB,t=-31.318,P=0.000].Conclusion The transvaginal removal of ectopic pregnancy tissue with repair of the uterine defect is safe,effective,minimally invasive and economical for patients with CSP.

关 键 词：剖宫产瘢痕妊娠 阴式手术 子宫动脉栓塞术 

分 类 号：R719.8[医药卫生—妇产科学]