宫腔镜宫内胚物电切治疗Ⅱ型剖宫产瘢痕妊娠  

The treatment of type Ⅱ CSP: Hysteroscopic resection for intrauterine embryo

作　　者：高艳华[1] 魏杏茹 李全香[1] 杨平芳 赵芳 GAO Yan-hua;WEI Xing-ru;LI Quan-xiang(The First Department of Gynaeclolgy,Baoding Maternal And Child Health Hospital,Baoding 071000,China.)

机构地区：[1]保定市妇幼保健院妇一科,河北保定071000

出　　处：《中国医学装备》2018年第8期72-75,共4页China Medical Equipment

基　　金：河北省保定市科学技术和知识产权局(17ZF055)"宫腹腔镜联合手术治疗Ⅲ型瘢痕妊娠的临床价值"

摘　　要：目的:探究宫腔镜宫内胚物电切术在Ⅱ型剖宫产瘢痕妊娠(CSP)中的临床应用价值。方法:选取110例Ⅱ型CSP患者,采用随机数表法将其随机分为观察组(56例)和对照组(54例),观察组患者采用宫腔镜宫内胚物电切术进行治疗,对照组患者则在B超监测下进行传统清宫术治疗,分别对两组患者的临床治疗情况、围术期情况、术后恢复情况以及并发症发生情况进行比较和分析。结果:观察组患者的治疗显效率为60.71%(34/56),总有效率为96.43%(54/56),均明显高于对照组,而无效率为3.57%(2/56),则明低于对照组,两组比较差异均具有统计学意义(x^2=4.388,x^2=0.003,x^2=9.812;P<0.05);观察组患者术中出血量和术后引流量均明显减少,手术时间明显缩短,与对照组比较差异均具有统计学意义(t=17.382,t=13.176,t=14.103;P<0.05);观察组患者的住院时间、人绒毛膜促性腺激素(β-HCG)恢复至正常时间及月经恢复正常时间均明显缩短,与对照组比较差异均有统计学意义(t=14.82,t=16.763,t=17.825;P<0.05);观察组患者发热、下肢疼痛、感染及邻近器官损伤等并发症总发生率明显低于对照组,其差异有统计学意义(x^2=4.010,P<0.05)。结论:宫腔镜宫内胚物电切术对于减轻Ⅱ型CSP患者机体创伤性以及加快患者术后恢复均具有极其重要的临床治疗价值。Objective： To explore and analyze the clinical application value of hysteroscopic resection for intrauterine embryo in the treatment of type Ⅱ cesarean scar pregnancy（CSP）. Methods： 110 patients with typeⅡCSP were divided into observation group（n=56） and control group（n=54） with random number table method. The patients of observation group were treated by using hysteroscopic resection for intrauterine embryo, while the patients of control group were treated by using traditionally complete curettage for uterine cavity under the supervision of B-mode ultrasound. The situation of clinical treatment, perioperative situation, postoperative recovery and complication of these patients between two groups were further analyzed and analyzed. Results： The effective rate of treatment（60.71%, 34/56） and total effective rate（96.43%, 54/56） of observation group were significantly higher than that of control group, and the inefficiency rate of observation group was significantly lower than that of control group（3.57%, 2/56）（x2=4.388, x2=0.003, x2=9.812, P〈0.05）. In the patients of observation group, the intraoperative blood loss and postoperative drainage volume were reduced significantly, the operation time was shortened significantly, and the differences of them between the two groups were statistically significant（t=17.382, t=13.176, t=14.103, P〈0.05）. And the hospitalization time, and the recovery times of human chorionic gonadotropin（β-HCG） and menstruation of observation group were significantly shortened, and the differences of them between the two groups were significant（t=14.82, t=16.763, t=17.825, P〈0.05）. Besides, the total occurrence rates of complications included fever, lower limb pain, infection, adjacent organ damage and others of observation group were significantly lower than that of control group（x2=4.010, P〈0.05）. Conclusions： Hysteroscopic resection for intrauterine embryo has extremely important value in clinical treatment for relieving trauma

关 键 词：Ⅱ型剖宫产瘢痕妊娠 宫腔镜电切术 宫内胚物 剖宫产术 

分 类 号：R454.1[医药卫生—治疗学]