经阴道或经腹腔镜手术治疗剖宫产瘢痕妊娠40例经验分析  

Clinical analysis of 40 cases of cesarean scar pregnancy treated by transvaginal or laparoscopic surgery

作　　者：范俊[1] 栾少红[1] 李婧[1] 秦文娜 安志洁[1] 陈龙[1] FAN Jun;LUAN Shao - hong;Ll Jing;QIN Wen - na;AN Zhi -jie;CHEN Long(Department of Gynecology, Qingdao Municipal Hospital Affiliated Medical College of Qingdao University, Qingdao Shandong 266071, P. R. China)

机构地区：[1]青岛大学医学院附属青岛市市立医院妇科,山东青岛266071

出　　处：《中国计划生育和妇产科》2018年第2期38-41,共4页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的总结经阴道或腹腔镜手术治疗剖宫产瘢痕妊娠(cesarean scar pregnancy,CSP)两种手术方式的不同适应证。方法回顾性分析青岛市市立医院2014年6月至2016年12月经阴道或经腹腔镜手术治疗的40例CSP患者病历资料,13例经阴道手术为研究组,27例经腹腔镜手术为对照组。比较两组的手术时间、术中出血量、术后住院时间、血β-人绒毛膜促性腺激素(β-human chorionic gonadotropin,β-h CG)降至正常的时间及住院费用等。结果两组患者出血量、术后血β-h CG降至正常时间及术后住院时间比较差异均无统计学意义(P>0.05);研究组手术时间、住院总费用明显少于对照组,差异有统计学意义(P<0.05)。结论经阴道或经腹腔镜治疗CSP两种手术方式均微创、有效,但经阴道手术所需时间及住院费用要低于经腹腔镜手术,术前需全面评估,根据患者不同情况选择最佳治疗方案。Objective To summarize the experiences of 40 cases of cesarean scar pregnancy who underwent transvaginal surgery or laparoscopic surgery, and to explore the different indications of the two surgical approaches. Methods The data of 40 cases of cesarean scar pregnancy underwent transvaginal surgery or laparoscopic surgery in Qingdao Municipal Hospital from June 2014 to December 2016 were analyzed retrospectively. 13 cases underwent transvaginal surgery, and 27 cases underwent laparoscopic surgery. The operation time, intraoperative blood loss volume, postoperative hospital stay, the time taken for blood β - hCG to return to normal and the total cost were compared between the two groups. Results All surgeries were successfully performed. There were no statistical significant differences between the two groups of intraoperative blood loss, the time taken for blood β - hCG to return to normal and postoperative hospital stay （ P 〉 0. 05 ） ; while both the operation time and postoperative hospital stay of the transvaginal group were significantly less than that of the laparoscopic group （P 〈 O. 05）. Conclusion The two kinds of surgical methods are both minimally invasive and effective, but the indications are different. Before operation, we need to evaluate comprehensively and choose the best treatment plan according to the patient~ different situation.

关 键 词：剖宫产瘢痕妊娠 阴道手术 腹腔镜手术 

分 类 号：R714.22[医药卫生—妇产科学]