剖宫产瘢痕妊娠临床分型与腹腔镜手术方式的选择  

Classification of Cesarean Section Scar Pregnancy and the Choice of Laparoscopic Surgery

作　　者：马丹 MA Dan(Department of Obstetrics and Gynecology,Fuzhou Fuxing Obstetrics and Gynecology Hospital,Fuzhou 350011,China)

机构地区：[1]福州福兴妇产医院妇产科,福建福州350011

出　　处：《中国医药指南》2021年第33期83-84,共2页Guide of China Medicine

摘　　要：目的探讨剖宫产瘢痕妊娠的临床分型结果以及腹腔镜手术方式的选择方法,为指导外科治疗提供支持。方法选择我院于2020年4月至2021年7月收治的31例剖宫产瘢痕妊娠患者为研究对象,根据患者的临床分型结果将其分为研究1组、研究2组以及研究3组,其中研究1组患者为瘢痕处宫腔内妊娠囊存活型,共15例,在腹腔镜手术治疗中接受腹腔镜下清宫术干预;研究2组12例患者的分型结果为瘢痕处肌层内妊娠囊型,在腹腔镜治疗方案的选择中采取了介入下子宫动脉栓塞联合清宫术干预;研究3组患者4例,临床分型结果为包块型或类滋养细胞型,腹腔镜治疗方案为双侧介入下双侧子宫动脉结扎联合瘢痕妊娠病灶切除术联合子宫修补术治疗。结果研究1组患者与研究2组患者的手术治疗成功率均为100%,研究3组1例转为子宫切除术,差异无统计学意义(P>0.05);3组患者的并发症发生率比较,组间差异无统计学意义(P>0.05)。结论在临床干预过程中,针对剖宫产瘢痕妊娠临床分型结果选择相应的腹腔镜手术治疗方法可以进一步提高手术治疗效果,因此医师在制订手术治疗方案中应充分了解患者剖宫产瘢痕妊娠临床分型,并尊重患者个体差异制订治疗方案,这样才能提高治疗效果。Objective To discuss the clinical classification results of cesarean section scar pregnancy and the selection method of laparoscopic surgery to provide support for guiding surgical treatment.Methods The 31 cases of cesarean section scar pregnancy patients admitted to our hospital between April 2020 and July 2021 were selected as the research objects.According to the clinical classification results of the patients,they were divided into study group 1,study group 2 and study group 3,of which the patients in the study group 1 were intrauterine gestational sac survival type at the scar,and there were 15 patients who received laparoscopic uterine evacuation intervention during laparoscopic surgery;the classification results of 12 patients in the study group 2 were scars in the selection of laparoscopic treatment plan,interventional uterine artery embolization combined with uterine evacuation intervention was adopted in the selection of muscular intramuscular gestational sac;4 patients in the study groups 3 were studied,the clinical classification results were mass type or trophoblast-like type,abdominal cavity The endoscopic treatment plan is bilateral uterine artery ligation combined with scar pregnancy lesion resection combined with uterine repair under bilateral intervention.Results The surgical treatment success rate of the study group 1 and study group 2 patients is 100%,and 1 case in the study group 3 was converted to hysterectomy,and the difference in data was not significant(P>0.05).The complication rate of patients showed that there was no significant difference between the groups(P>0.05).Conclusion In the process of clinical intervention,choosing the corresponding laparoscopic surgical treatment method according to the clinical classification results of cesarean section scar pregnancy can further improve the surgical treatment effect.Therefore,doctors should fully understand the patient's cesarean section scar pregnancy when formulating surgical treatment plans.The results of clinical classification,and resp

关 键 词：剖宫产瘢痕妊娠 腹腔镜手术 临床分型 术后并发症 

分 类 号：R719.8[医药卫生—妇产科学]