宫腔镜与腹腔镜治疗内生型剖宫产瘢痕妊娠的比较  

Comparison of Hysteroscopic and Laparoscopic Treatment for Endogenous Type Cesarean Section Scar Pregnancy

作　　者：傅君[1] 黄勇[1] 

机构地区：[1]宁波市妇女儿童医院妇产科,宁波315012

出　　处：《中国微创外科杂志》2015年第10期894-896,共3页Chinese Journal of Minimally Invasive Surgery

基　　金：浙江省医药卫生科技项目(项目编号:2014KYB358)

摘　　要：目的：探讨宫腔镜切除术治疗内生型剖宫产瘢痕妊娠（cesarean scar pregnancy，CSP）的安全性及可行性。方法2012年8月～2014年2月58例内生型 CSP 分别采用宫腔镜下切除（宫腔镜组，n ＝31）和腹腔镜手术（腹腔镜组，n ＝27），对2组术中出血量、手术时间、术后住院时间、术后宫腔引流量、术后血β-hCG 恢复正常时间及月经恢复正常时间进行比较。结果宫腔镜组术中出血量（109±59）ml，明显少于腹腔镜组（143±63）ml（t ＝－2．121，P ＝0．038）；手术时间（43．7±17．5）min，明显短于腹腔镜组（100．8±18．8）min（t ＝－11．974，P ＝0．000）；术后住院时间（3．8±0．7）d，明显短于腹腔镜组（4．5±0．6）d（t ＝－4．057，P ＝0．000）；月经恢复正常时间（43．8±3．9）d，明显短于腹腔镜组（45．9±3．8）d（t ＝－2．070，P ＝0．043）。2组术后子宫腔引流量分别为（22．1±2．8）ml 和（23．6±3．2）ml，无统计学差异（t ＝－1．904，P ＝0．062）。2组血β-hCG降至正常时间分别为（20．5±7．7）d 和（22．9±9．3）d，无统计学差异（t ＝－1．075，P ＝0．287）。结论宫腔镜手术治疗内生型 CSP 出血少、住院时间短，恢复快。Objective To evaluate the safety and feasibility of hysteroscopy in the treatment of endogenous type cesarean section scar pregnancy （CSP）. Methods Clinical data of 58 cases of CSP from August 2012 to February 2014 in our hospital were analyzed retrospectively.Thirty-one cases were treated by hysteroscopy,while 27 cases were treated by laparoscopy.The intraoperative blood loss,operation time,postoperative hospital stay,postoperative drainage of uterine cavity,β-hCG level resolution time and time to menstruous restoration were compared between the two groups. Results The intraoperative blood loss,operation time,length of hospitalization after operation,and time to menstruous restoration were statistically lower in the hysteroscopy group than those in the laparoscopy group [（109 ±59）ml vs.（143 ±63）ml,t =-2.121 ,P =0.038;（43.7 ±17.5）min vs.（100.8 ±18.8）min,t =-1 1 .974,P =0.000;（3.8 ±0.7）d vs.（4.5 ±0.6）d,t =-4.057,P =0.000;（43.8 ±3.9）d vs.（45.9 ±3.8）d,t =-2.070,P =0.043].There were no significant differences in postoperative drainage of uterine cavity and β-hCG level resolution time between the two groups [（22.1 ±2.8）ml vs.（23.6 ±3.2）ml,t =-1 .904,P =0.062;（20.5 ±7.7）d vs.（22.9 ±9.3）d,t =-1 .075,P =0.287]. Conclusion Hysteroscopy has advantages of less intraoperative blood loss,shorter hospitalization time and quicker recovery in the treatment of endogenous type CSP.

关 键 词：剖宫产瘢痕妊娠 内生型 宫腔镜 腹腔镜 

分 类 号：R713.8[医药卫生—妇产科学]