腹腔镜下疤痕妊娠病灶清除及修补术的临床效果分析  

Clinical effect and safety analysis of laparoscopic cesarean scar pregnancy debridement and repair surgery

作　　者：徐海霞[1] 伊碧霞[1] 徐攀[1] 宋莹[1] XU Hai-xia;YI Bi-xia;XU Pan;SONG Ying(Department of Obstetrics and Gynecology,Jinhua People＇s Hospital,Zhejiang Jinhua 321000,China)

机构地区：[1]浙江省金华市人民医院妇产科,浙江金华321000

出　　处：《中国妇幼健康研究》2018年第11期1483-1487,共5页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨腹腔镜下疤痕妊娠病灶清除和疤痕修补术的临床效果及安全性。方法选取2014年1月至2017年5月金华市人民医院收治的66例子宫疤痕妊娠患者,随机将其分成对照组(36例)和观察组(30例)。对照组采用经腹子宫疤痕妊娠病灶切除术及疤痕修补术治疗,观察组采用腹腔镜下疤痕妊娠病灶清除及疤痕修补术治疗。比较两组患者治疗后的临床效果、术中出血量、手术时间、术后恢复情况及并发症情况。结果观察组患者接受治疗后的总有效率(96.67%)显著高于对照组患者(77.78%),经比较差异有统计学意义(χ~2=4.9575,P<0.05);观察组患者的术中出血量和手术时间均明显少于对照组患者,经比较差异均有统计学意义(t值分别为15.0982、11.1660,均P<0.05);观察组患者术后阴道流血时间、β-人绒毛膜促性腺激素恢复至正常水平时间、病灶缩小时间、月经恢复时间及住院时间均少于对照组患者,经比较差异均有统计学意义(t值分别为5.7653、2.2944、2.3958、2.9988、6.8220,均P<0.05);观察组患者术后总的并发症发生率(13.33%)显著低于对照组患者(38.89%),经比较差异有统计学意义(χ~2=5.3880,P<0.05)。结论腹腔镜下疤痕妊娠病灶清除及疤痕修补术临床效果显著,患者术中出血少,手术时间短,术后恢复快,且安全性高,具有较高的临床推广应用价值。Objective To investigate the clinical effect and safety of laparoscopic cesarean scar pregnancy debridement and repair surgery.Methods Sixty-six patients with uterine scar pregnancy admitted in Jinhua People＇s Hospital from January 2014 to May 2017 were studied.The selected subjects were randomly divided into control group（36 cases）and observation group（30 cases）.Abdominal cesarean scar pregnancy debridement and repair surgery was performed in the control group and laparoscopic cesarean scar pregnancy debridement and repair surgery was performed in the observation group.The clinical effects,amount of intraoperative blood loss,operation time,postoperative recovery and complications were compared between two groups.Results The total effective rate（96.67%）in the observation group was higher than that in the control group（77.78%）,and the difference was statistically significant（χ~2=4.9575,P〈0.05）.The intraoperative blood loss and operation time in the observation group were significantly lower and shorter than those in the control group with significant differences（t value was 15.0982 and 11.1660,respectively,both P〈0.05）.The postoperative vaginal bleeding time,time for HCG returning to normal level,lesion reduction time,menstruation recovery time and length of hospital stay in the observation group were less than those in the control group with significant differences（t value was 5.7653,2.2944,2.3958,2.9988 and 6.8220,respectively,all P〈0.05）.The incidence of postoperative complications in the observation group（13.33%）was lower than in the control group（38.89%）,and the difference was statistically significant（χ~2=5.3880,P〈0.05）.Conclusion Clinical effect of laparoscopic cesarean scar pregnancy debridement and repair surgery is obvious with less intraoperative bleeding,shorter operative time,faster recovery and higher safety,and it obtains high clinical application value.

关 键 词：腹腔镜 疤痕妊娠病灶清除术 疤痕修补术 子宫疤痕妊娠 临床效果 

分 类 号：R714.2[医药卫生—妇产科学]