阴式病灶切除联合子宫壁修补术治疗剖宫产后子宫瘢痕妊娠疗效观察  

Effect of transvaginal lesion resection combined with uterine wall repair on cesarean scar pregnancy

作　　者：陈静平 陆媛媛 韦任姬 刘丽娟 韦木兰 CHEN Jingping;LU Yuanyuan;WEI Renji;LIU Lijuan;WEI Mulan(Department of Gynaecology,the Eighth Affiliated Hospital of Guangxi Medical University/Guigang People's Hospital,Guigang 537100,Guangxi Province,China)

机构地区：[1]广西医科大学第八附属医院/贵港市人民医院妇科,广西贵港537100

出　　处：《新乡医学院学报》2022年第1期55-59,共5页Journal of Xinxiang Medical University

摘　　要：目的探讨阴式病灶切除联合子宫壁修补术治疗剖宫产后子宫瘢痕妊娠(CSP)的临床效果。方法选择2015年8月至2017年7月广西医科大学第八附属医院/贵港市人民医院收治的124例CSP患者为研究对象,根据手术方式将患者分为观察组(n=56)和对照组(n=68)。观察组患者采用阴式病灶切除联合子宫壁修补术治疗,对照组患者采用子宫动脉栓塞术(UAE)联合清宫术治疗。于术前和术后第3、5、7天,采集2组患者空腹静脉血3~4 mL,采用时间分辨荧光免疫分析法检测血人绒毛膜促性腺激素(β-HCG)水平;比较2组患者总有效率、术中出血量、手术时间、阴道出血时间、住院时间、治疗费用、血β-HCG转阴时间和月经复潮时间。结果术前对照组与观察者患者血清β-HCG水平比较差异无统计学意义(P>0.05);术后第3、5、7天,2组患者血清β-HCG水平呈逐渐降低趋势(P<0.05),观察组患者血清β-HCG水平显著低于对照组(P<0.05)。观察组患者的总有效率为96.43%(54/56),对照组患者的总有效率为85.29%(58/68);观察组患者治疗总有效率显著高于对照组(χ^(2)=4.356,P<0.05)。观察组患者术中出血量显著多于对照组,手术时间显著长于对照组,阴道出血时间和住院时间显著短于对照组,治疗费用显著少于对照组(P<0.05)。观察组患者术后血β-HCG转阴时间和月经复潮时间显著短于对照组(P<0.05)。结论与UAE联合清宫术相比,阴式病灶切除联合子宫壁修补术治疗CSP疗效显著,可快速降低血β-HCG水平、促进术后恢复。Objective To investigate the clinical effect of transvaginal lesion resection combined with uterine wall repair in the treatment of cesarean scar pregnancy(CSP).Methods A total of 124 patients with CSP admitted to the Eighth Affiliated Hospital of Guangxi Medical University/Guigang People's Hospital from August 2015 to July 2017 were selected as the research subjects,and they were divided into observation group(n=56)and control group(n=68)according to the operation method.The patients in the observation group were treated with transvaginal lesion resection combined with uterine wall repair,while the patients in the control group were treated with uterine artery embolization(UAE)combined with uterine curettage.Before operation and on the 3^(rd),5^(th) and 7^(th) day after operation,3-4 mL of fasting venous blood was collected from patients in the two groups,the time-resolved fluorescence immunoassay was used to detect blood β-human chorionic gonadotropin(β-HCG)level.The total effective rate,intraoperative blood loss,operation time,vaginal bleeding volume,hospitalization time,treatment cost,the time of blood β-HCG returning to negative and the time of menstrual recovery of patients between the two groups were compared.Results There was no significant difference in serum β-HCG level between the two groups before operation(P>0.05).On the 3^(rd),5^(th) and 7^(th) after operation,the serum β-HCG levels of patients in the two groups showed a decreasing trend(P<0.05),and the serum β-HCG level of patients in the observation group was significantly lower than that in the control group(P<0.05).The total effective rate of patients in the observation group was 96.43%(54/56),the total effective rate of patients in the control group was 85.29%(58/68);the total effective rate of patients in the observation group was significantly higher than that in the control group(χ^(2)=4.356,P<0.05).The intraoperative blood loss in the observation group was significantly more than that in the control group,the operation time was signi

关 键 词：子宫瘢痕妊娠 阴式切除术 子宫动脉栓塞术 子宫壁修补 

分 类 号：R713.8[医药卫生—妇产科学]