经阴道病灶清除术治疗剖宫产瘢痕妊娠的疗效  

Clinical efficacy and safety of transvaginal cesarean scar pregnancy debridement surgery in the treatment of cesarean scar pregnancy:A retrospective cohort study

作　　者：李爱明[1] 王明全[2] 白雪[1] 范淑静[1] 谢彩霞[1] LI Aiming;WANG Mingquan;BAI Xue;FAN Shujing;XIE Caixia(Clinical Faculty of the Department of Obstetrics and Gynecology,Yan'an People's Hospital,Yan'an 716000,China;Department of Interventional Medicine,Affiliated Hospital of Yan'an University,Yan'an 716000,China)

机构地区：[1]延安市人民医院妇产科临床教研室,陕西延安716000 [2]延安大学附属医院介入科,陕西延安716000

出　　处：《中国妇幼健康研究》2019年第11期1439-1442,共4页Chinese Journal of Woman and Child Health Research

基　　金：陕西省卫计委科技计划资助项目(编号:2016D081)

摘　　要：目的分析经阴道剖宫产瘢痕妊娠病灶清除术(TCSPDS)治疗剖宫产瘢痕妊娠(CSP)的疗效和安全性。方法回顾性分析延安市人民医院2010年2月至2017年2月收治的CSP患者42例,其中26例采用子宫动脉栓塞联合MTX药物局部注射、刮宫术等治疗(UAE组),16例采用经TCSPDS术(TCSPDS组)治疗。比较两组手术的成功率、术中出血时间、手术时间、住院时间、围手术期并发症情况。结果与UAE组比较,TCSPDS组手术成功率显著高于UAE组(100.0%vs. 73.1%,χ~2=5.17,P=0.02);TCSPDS组手术时间(t=9.54,P<0.01)、术中出血量(t=14.6,P<0.01)和住院时间(t=14.9,P<0.01)显著低于UAE组;TCSPDS组术后并发症发生率显著减少(χ~2=6.13,P=0.01),1周后β-绒毛膜促性腺激素(β-hCG)水平显著降低(t=8.76,P<0.05)。结论经阴道剖宫产瘢痕妊娠病灶清除术治疗剖宫产瘢痕妊娠,有效且安全,值得临床推广使用。Objective The present study aimed to discuss the clinical efficacy and safety of transvaginal cesarean scar pregnancy debridement surgery(TCSPDS) in the treatment of patients with cesarean scar pregnancy(CSP).Methods A retrospective analysis was performed on 42 CSP patients admitted during the period from February 2010 to February 2017.For the included 42 cases,26 were treated with uterine artery embolization(UAE) and 16 were treated with TCSPDS.The operation success rate,intraoperative blood loss,operation time,length of hospital stay,perioperative complications,and β-HCG level were compared.Results The success rate in TCSPDS was markedly higher than UAE group(100% vs.73.1%,χ~2=5.17,P=0.02).For the LCSPDS group,operation time(t=9.54,P<0.001),intraoperative blood loss(t=14.6,P<0.001),length of hospital stay(t=14.9,P<0.001),perioperative complications(χ~2=6.13,P=0.01),β-hCG level after one week(t=8.76,P<0.05) were all significantly decreased when compared with the control group.Conclusion Transvaginal cesarean scar pregnancy debridement surgery(TCSPDS) is an effective and safe treatment in the treatment of patients with cesarean scar pregnancy.

关 键 词：经阴道剖宫产瘢痕妊娠病灶清除术 剖宫产瘢痕妊娠 疗效 安全性 

分 类 号：R713.8[医药卫生—妇产科学]