腹腔镜下妊娠病灶切除术对Ⅱ、Ⅲ型剖宫产瘢痕部位妊娠患者术后康复效果及卵巢内分泌功能的影响  

Effects of laparoscopic resection of pregnancy focus on postoperative rehabilitation and ovarian endocrine function of patients with typeⅡandⅢcesarean scar pregnancy

作　　者：黄海龙 王毅 郑瑞霞 HUANG Hailong;WANG Yi;ZHENG Ruixia(Dongguan Binhai Bay Central Hospital,Dongguan 523900,China)

机构地区：[1]东莞市滨海湾中心医院,广东东莞523900

出　　处：《临床医学研究与实践》2022年第2期124-126,共3页Clinical Research and Practice

摘　　要：目的探讨腹腔镜下妊娠病灶切除术对Ⅱ、Ⅲ型剖宫产瘢痕部位妊娠(CSP)患者术后康复效果及卵巢内分泌功能的影响。方法回顾性分析2019年3月至2021年2月就诊于我院的70例Ⅱ、Ⅲ型CSP患者的临床资料,根据不同治疗方式将其分为A组(n=35,腹腔镜下妊娠病灶切除术)与B组[n=35,双侧子宫动脉栓塞术(UAE)联合清宫术]。比较两组患者的手术指标及术后康复情况;比较两组患者术前、术后的卵巢内分泌功能。结果A组的手术时间、血HCG下降至正常时间、月经复潮时间、住院时间明显短于B组,术中出血量明显少于B组,差异具有统计学意义(P<0.05)。术前,两组的血清P、E_(2)、PRL、FSH、LH水平比较,差异无统计学意义(P>0.05);术后,两组的血清P、E_(2)、PRL水平均较术前明显降低,且A组低于B组,差异具有统计学意义(P<0.05);术后,两组的血清FSH、LH水平均较术前明显升高,且A组高于B组,差异具有统计学意义(P<0.05)。结论腹腔镜下妊娠病灶切除术对Ⅱ、Ⅲ型CSP的疗效确切,具有高效、微创、安全性高等优势,对卵巢功能影响较小,值得临床推广。Objective To investigate the effects of laparoscopic resection of pregnancy focus on postoperative rehabilitation and ovarian endocrine function of patients with typeⅡandⅢcesarean scar pregnancy(CSP).Methods The clinical data of 70 patients with typeⅡandⅢCSP treated in our hospital from March 2019 to February 2021 were retrospectively analyzed.According to different treatment methods,the patients were divided into group A(n=35,laparoscopic resection of pregnancy focus)and group B[n=35,bilateral uterine artery embolization(UAE)combined with complete curettage of uterine cavity].The operation indexes and postoperative rehabilitation of patients in the two groups were compared;the ovarian endocrine function before and after operation were compared between the two groups.Results The operation time,time of blood HCG decreasing to normal,menstrual rehydration time and hospital stay in the group A were significantly shorter than those in the group B,the amount of intraoperative bleeding was significantly less than that in the group B,and the differences were statistically significant(P<0.05).Before operation,there were no significant differences in the levels of serum P,E_(2),PRL,FSH and LH between the two groups(P>0.05);after operation,the levels of serum P,E_(2) and PRL in the two groups were significantly lower than those before operation,and those in the group A were lower than the group B,the differences were statistically significant(P<0.05);after operation,the levels of serum FSH and LH in the two groups were significantly higher than those before operation,and those in the group A were higher than the group B,the differences were statistically significant(P<0.05).Conclusion Laparoscopic resection of pregnancy focus has definite curative effect on typeⅡandⅢCSP.It has the advantages of high efficiency,minimally invasive and high safety,and has little impact on ovarian function,which is worthy of clinical promotion.

关 键 词：剖宫产瘢痕部位妊娠 腹腔镜下妊娠病灶切除术 子宫动脉栓塞术 清宫术 卵巢内分泌功能 月经复潮时间 住院时间 术中出血量 

分 类 号：R713.8[医药卫生—妇产科学]