药物预处理辅助宫腔镜下清宫术治疗Ⅱ型剖宫产瘢痕妊娠的临床研究  

Clinical study of pharmacological preconditioning assisted hysteroscopic curettage in the treatment of type Ⅱ cesarean scar pregnancy

作　　者：张晓慧 李善华 ZHANG Xiaohui;LI Shanhua(Department of Gynecology,Zhucheng people's Hospital,Weifang City,Weifang,Shandong,262200,China;First Department of Gynecology,Zaozhuang Maternal and Child Health Hospital,Zaozhuang,Shandong,277000,China)

机构地区：[1]潍坊市诸城市人民医院妇科,山东潍坊262200 [2]枣庄市妇幼保健院妇一科,山东枣庄277000

出　　处：《当代医学》2024年第2期106-109,共4页Contemporary Medicine

摘　　要：目的探讨药物预处理辅助宫腔镜下清宫术治疗Ⅱ型剖宫产瘢痕妊娠(CSP)的临床疗效。方法选取2016年9月至2021年12月在诸城市人民医院和枣庄市妇幼保健院住院治疗的42例Ⅱ型CSP患者作为研究对象,根据宫腔镜下清宫术前有无药物预处理分为研究组(n=22)与对照组(n=20)。研究组给予米非司酮+米索前列醇术前预处理后行宫腔镜下清宫术,对照组单纯行宫腔镜下清宫术。比较术后恢复情况、术后并发症、初始治愈率和住院情况。结果两组血清人绒毛膜促性腺激素β亚基(β-HCG)恢复时间、术后并发症发生率、初始治愈率比较差异无统计学意义。研究组术中出血量、住院费用均少于对照组,阴道出血时间、月经恢复时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。结论药物预处理辅助宫腔镜下清宫术治疗Ⅱ型CSP疗效确切,患者术中出血量少,术后恢复快,安全性高,值得临床推广应用。Objective To explore the clinical efficacy of pharmacological preconditioning assisted hysteroscopic curettage in the treatment of typeⅡcesarean scar pregnancy(CSP).Methods 42 patients with typeⅡCSP hospitalized in Zhucheng People's Hospital and Zaozhuang Maternal and Child Health Hospital from September 2016 to December 2021 were selected as study subjects,and they were divided into the study group(n=22)and the control group(n=20)according to whether or not there was pharmacological preconditioning before hysteroscopic curettage.The study group received mifepristone+misoprostol preoperative pretreatment,and then underwent hysteroscopic curettage,while the control group only underwent hysteroscopic curettage.The postoperative recovery,postoperative complications,initial cure rate and hospitalization of the two groups were compared.Results There were no significant differences in the recovery time of serum β-HCG,the incidence of postoperative complications and the initial cure rate between the two groups.The amount of intraoperative bleeding and hospitalization expenses in the study group were less than those in the control group,and the time of vaginal bleeding,menstrual recovery time and hospitalization time were shorter than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Pharmacological preconditioning assisted hysteroscopic curettage is effective in the treatment of type Ⅱ cesarean scar pregnancy,with less intraoperative blood loss,rapid postoperative recovery and high safety,which is worthy of clinical promotion and application.

关 键 词：Ⅱ型剖宫产瘢痕妊娠 米非司酮 米索前列醇 宫腔镜 清宫术 

分 类 号：R714.22[医药卫生—妇产科学]