宫腔镜手术治疗Ⅰ型剖宫产瘢痕妊娠的临床疗效  

Clinical Efficacy of Hysteroscopic Surgery for TypeⅠCesarean Scar Pregnancy

作　　者：方丽萍 李妮[1] 任晓丽 FANG Liping;LI Ni;REN Xiaoli(Department of Gynecology,Xi'an High-tech Hospital,Xi'an Shaanxi 710082)

机构地区：[1]西安高新医院妇科,陕西西安710082

出　　处：《医学临床研究》2023年第9期1361-1363,1367,共4页Journal of Clinical Research

摘　　要：【目的】探讨宫腔镜手术治疗Ⅰ型剖宫产瘢痕妊娠(CSP)患者的临床疗效。【方法】选取2015年1月至2019年10月本院收治的80例Ⅰ型CSP患者,其中在宫腔镜下行瘢痕妊娠病灶电切术30例(宫腔镜组),行子宫动脉栓塞介入联合负压吸引清宫术50例(清宫组)。比较两组术中出血量、手术时间、住院时间、包块吸收时间、术后子宫功能相关指标[月经期、月经量、月经恢复时间、人绒毛膜促性腺激素(HCG)水平、HCG恢复时间、阴道流血时间]、手术前后孕妇心理变化[焦虑自评表(SAS)评分、抑郁自评表(SDS)评分]、并发症发生率。【结果】宫腔镜组术中出血量、手术时间、住院时间、月经恢复时间、HCG恢复时间、阴道流血时间明显少于清宫组,HCG水平明显低于清宫组,差异均有统计学意义(P<0.05);宫腔镜组术后SAS评分、SDS评分明显低于同组术前和清宫组术后,差异有统计学意义(P<0.05);宫腔镜组并发症发生率为10.00%,与清宫组的14.00%比较,差异无统计学意义(P>0.05)。【结论】与介入栓塞联合清宫术比较,宫腔镜手术治疗Ⅰ型CSP的疗效较好,患者子宫功能恢复快、心理状态健康,值得临床推广。【Objective】To explore the clinical efficacy of hysteroscopic surgery for typeⅠcesarean scar pregnancy(CSP)patients.【Methods】A total of 80 patients with TypeⅠCSP admitted to our hospital from January 2015 to October 2019 were selected.Among them,30 patients underwent hysteroscopic resection of scar pregnancy lesions(hysteroscopic group),and 50 patients underwent uterine artery embolization intervention combined with negative pressure suction curettage(curettage group).We compared the intraoperative bleeding volume,surgical time,hospital stay,lump absorption time,and postoperative uterine function related indicators[Menstrual period,menstrual volume,menstrual recovery time,human chorionic gonadotropin(HCG)levels,HCG recovery time,vaginal bleeding time],Psychological changes of pregnant women before and after surgery[Self Rating Anxiety Scale(SAS)score,Self Rating Depression Scale(SDS)score],and the incidence of complications.between the two groups.【Results】The intraoperative bleeding volume,surgical time,hospitalization time,menstrual recovery time,HCG recovery time,and vaginal bleeding time in the hysteroscopy group were significantly lower than those in the curettage group,with statistical significance(P<0.05).The HCG level was significantly lower than that in the curettage group,with statistical significance(P<0.05);The postoperative SAS and SDS scores of the hysteroscopy group were significantly lower than those of the same group before and after the curettage group,and the difference was statistically significant(P<0.05);The incidence of complications in the hysteroscopy group was 10.00%,and there was no statistically significant difference compared to the 14.00%in the curettage group(P>0.05).【Conclusion】Compared with interventional embolization combined with curettage,hysteroscopic surgery has a better therapeutic effect on TypeⅠCSP,with fast recovery of uterine function and healthy psychological state,which is worthy of clinical promotion.

关 键 词：宫腔镜检查 剖宫产术/副作用 妊娠 异位 瘢痕 

分 类 号：R714.3[医药卫生—妇产科学]