经阴道手术治疗剖宫产疤痕妊娠有效性和安全性分析  

Clinical efficacy and safety of transvaginal surgery in the treatment of cesarean scar pregnancy

作　　者：赵娟娟[1] 

机构地区：[1]公安县人民医院妇科,湖北公安434300

出　　处：《海南医学》2018年第3期429-431,共3页Hainan Medical Journal

摘　　要：目的分析经阴道手术治疗剖宫产疤痕妊娠的有效性和安全性。方法将2014年1月至2017年1月期间在公安县人民医院住院治疗的93例剖宫产疤痕妊娠患者根据治疗方法分为两组,常规治疗组45例患者予以B超阴道下负压吸宫术,而经阴道手术组48例患者予以经阴道子宫疤痕病灶清除术;随访3个月,比较两组患者的治疗效果、术中及术后情况。结果常规治疗组患者β-HCG转阴时间、剖宫产疤痕部位包块消失时间显著大于经阴道手术组,术后3个月切口肌层厚度明显小于经阴道手术组,且治愈率明显低于经阴道手术组,差异均有统计学意义(P<0.01);常规治疗组患者手术时间及术中出血量明显少于经阴道手术组,住院时间、阴道流血时间、正常月经恢复时间均明显大于经阴道手术组,差异均有显著统计学意义(P<0.01);常规治疗组和经阴道手术组的并发症发生率分别为13.3%、16.7%,差异无统计学意义(P>0.05)。结论经阴道手术治疗剖宫产疤痕妊娠具有较好的治疗效果和可靠的安全性。Objective To analyze the clinical efficacy and safety of transvaginal surgery in the treatment ofcesarean scar pregnancy. Methods Ninety-three patients with cesarean scar pregnancy treated in People＇s Hospital ofGong＇an County from January 2014 to January 2017, according to the treatment method, were divided into two groups.The conventional treatment group （n=45） were given negative pressure aspiration under the guidance of transvaginal ul-trasound, and the transvaginal surgery group （n=48） were given transvaginal cesarean scar pregnancy debridement. Af-ter 3-month follow-up, the curative effect, intraoperative and postoperative conditions of two groups were compared.Results The β-HCG clearance time, disappear time of mass in cesarean scar in the conventional treatment group weresignificantly longer than those of transvaginal surgery group （P〈0.01）, and the 3-month postoperative incision musclelayer thickness was significantly smaller than that of the transvaginal surgery group （P〈0.01）. The curative rate was sig-nificantly lower than that of the transvaginal surgery group （P〈0.01）. The operative time and intraoperative blood loss ofthe conventional treatment group were significantly less than those of the transvaginal surgery group （P〈0.01）. Thelength of hospital stay, duration of vaginal bleeding, and normal menstrual recovery time of the conventional treatment group were significantly longer than those of the transvaginal surgery group （P〈0.01）. The complication occurrence rates of the conventional treatment group and the transvaginal surgery group were respectively 13.3% and 16.7%, and the dif- ference was not statistically significant （P〉0.05）. Conclusion Transvaginal surgery for the management of cesarean scar pregnancy has better clinical treatment effect and more reliable safety, compared with negative pressure aspiration.

关 键 词：经阴道手术 子宫疤痕妊娠 病灶清除术 临床疗效 安全性 

分 类 号：R719.8[医药卫生—妇产科学]