有生育要求的Ⅲ型CSP手术治疗效果临床研究  

Clinical study on the effect of surgical treatment of type Ⅲ CSP patients with fertility requirements

作　　者：刘明博[1] 刘禄斌[1] 卢深涛 袁源 王荥[1] 赵成志 雷丽[1] Liu Mingbo;Liu Lubin;Lu Shentao;Yuan Yuan;Wang Ying;Zhao Chengzhi;Lei Li(Department of Gynecological Pelvic Floor and Oncology,Chongqing Health Center for Women and Children)

机构地区：[1]重庆市妇幼保健院妇科盆底与肿瘤科,重庆400013

出　　处：《重庆医科大学学报》2021年第12期1526-1528,共3页Journal of Chongqing Medical University

基　　金：重庆市妇幼保健院青年培育资助项目(编号:2019YJQN04)。

摘　　要：目的:探讨有生育要求的Ⅲ型瘢痕妊娠(cesarean scar pregnancy,CSP)阴式及腹腔镜病灶切除修补术(focal excision repair,FER)手术方式的临床价值。方法:回顾分析2017年1月至2019年12月重庆市妇幼保健院收治的有生育要求的Ⅲ型CSP并行非介入辅助下阴式FER 55例及腹腔镜FER 36例。结果:88例手术顺利,阴式FER术中出血(116.6±33.3) mL,手术时间(68.0±13.3) min,腹腔镜FER术中出血(150.6±31.6) mL,手术时间(107.0±13.3) min;2种手术出血量和手术时间统计学差异明显(P<0.05),阴式FER住院费用明显低于腹腔镜FER(P<0.05),术后1年超声随访阴式FER切口瘢痕厚度[(4.66±0.30) mm]较腹腔镜FER[(4.06±0.37) mm]厚(P<0.05),术后18个月后妊娠情况无统计学差异(P>0.05)。结论:2种手术方式治疗Ⅲ型CSP各有利弊,非紧急情况下可以避免使用子宫动脉栓塞术(uterus artery embolization,UAE)。Objective :To explore the clinical treatment effects of two surgical methods of type Ⅲ cesarean scar pregnancy(CSP) vaginal and laparoscopic focal excision repair(FER) with fertility requirements. Methods:Retrospective analysis was made on 55 cases of type Ⅲ CSP with fertility requirements taking non-invasive assisted vaginal FER and 36 cases of laparoscopic FER admitted to Chongqing Health Center for Women and Children from January 2017 to December 2019. Results :The operation went smoothly among 88 cases. The bleeding during vaginal FER operation was(116.6±33.3) mL,and the operation time was(68.0±13.3) min;the bleeding during laparoscopic FER operation was(150.6±31.6) mL,and the operation time was(107.0±13.3) min. There were significant differences in the bleeding volume and operation time among the two kinds of operations(P<0.05). The hospitalization cost of vaginal FER was significantly lower than that of laparoscopic FER(P<0.05). The scar thickness of female FER incision[(4.66±0.30) mm] was significantly greater than that of laparoscopic FER[(4.06±0.37) mm] in one-year of ultrasound follow-up after operation(P<0.05),and there was no significant difference in pregnancy after 18 months(P>0.05). Conclusion :There are advantages and disadvantages of the two surgical methods for type Ⅲ CSP,and uterus artery embolization(UAE) can be avoided in non-emergency situations.

关 键 词：阴式 腹腔镜 Ⅲ型CSP 病灶切除修补术 

分 类 号：R713[医药卫生—妇产科学]