宫腹腔镜联合与清宫术治疗子宫瘢痕妊娠的疗效对比分析  

Efficacy Comparison of laparoscopic surgery and uterine curettage for the treatment of uterine scar pregnancy

作　　者：马舒宁 赖微[1] 

机构地区：[1]四川省妇幼保健院.四川省妇女儿童医院手术室,四川成都610041

出　　处：《中国计划生育和妇产科》2016年第12期51-54,共4页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的探讨宫腹腔镜联合与清宫术治疗子宫瘢痕妊娠(cesarean scar pregnancy,CSP)的疗效。方法选取2013年8月至2015年10月四川省妇幼保健院61例CSP患者,根据不同治疗方案分为两组,采用宫腹腔镜手术联合治疗的31例为研究组,采用宫腔镜下清宫术治疗的30例为对照组,观察两组患者手术基本情况(成功率、手术时间、手术失血量、膨宫液使用量、住院时间),随访患者3月,对比两组术后恢复情况[(阴道流血时间、月经恢复时间、血β-人绒毛膜促性腺激素(human chorionic gonadotropin,β-HCG)恢复正常时间]。结果研究组手术成功率(100%)显著高于对照组(66.67%),差异有统计学意义(P<0.05);研究组手术时间[(74.59±13.61)min]、手术失血量[(69.52±17.48)m L]、住院时间[(6.21±1.03)d]均显著少于对照组[(115.24±27.45)min、(90.41±20.53)m L、(9.14±1.27)d],差异有统计学意义(P<0.05);研究组阴道流血时间[(16.34±3.12)d]、月经恢复时间[(30.69±4.73)d]、血β-HCG恢复正常时间[(21.32±7.14)d]均显著少于对照组[(24.57±8.26)d、(41.72±8.15)d、(33.65±12.09)d],差异有统计学意义(P<0.05)。结论宫腹腔镜联合治疗CSP疗效显著,与清宫术相比,手术时间更短、失血量更少、术后恢复更快。Objective To compare laparoscopy and curettage for the treatment of uterine scar pregnancy. Methods From August 2013 to October 2015, 61 cases of uterine scar pregnancy were selected in Maternal and Child Health Care Hospital of Sichuan Province. According to patients＇ condition, doctors＇ advice and treatment will they were divided into two groups. The research group was trearted by hysteroscopy and laparoseopy, while the control group was treated by uterine curettage under hysteroscopy. Compare the two groups with the basic situations of surgery （success rate, operation time, surgical blood loss, volume of uterine fluid usage and hospital stay）. The patients were followed up for 3 months, and the recovery of the two groups was compared （vaginal bleeding time, menstruation recovery time and blood human chorionic gunadotropin beta - HCG recovery time）. Results Success rate of operation in the research group （100%） was significantly higher than that in the control group （66. 67% ）. Statistically, the difference was highly significant （ P 〈 0.05 ）. The operation time, intraoperative blood loss and length of hospital stay of the research group were significantly lower than those of the control group. The differences were of statistical significance （ P 〈 0. 05 ）. The vaginal bleeding time, menstruation recovery time and blood beta 13 - HCG recovery time of the research group were significantly lower than those of the control group. The differences were of statistical significance （P 〈 0. 05）. Conclusion the efficacy of laparoscopy and hysteroscopy for the treatment of uterine scar pregnancy is more significant compared with the dilatation and curettage with shorter operation time, less blood loss, and faster postoperation recovery.

关 键 词：宫腹腔镜 清宫术 子宫瘢痕妊娠 

分 类 号：R714.2[医药卫生—妇产科学]