阴式病灶切除联合子宫壁修补术治疗剖宫产瘢痕部位妊娠的效果  

Effectiveness of Vaginal Lesion Resection Combined with Uterine Wall Repair in the Treatment of Uterine Scar Pregnancy after Caesarean Section

作　　者：张鑫[1] ZHANG Xin(Xintai People's Hospital,Xintai 271200,China)

机构地区：[1]新泰市人民医院,山东新泰271200

出　　处：《中外医学研究》2024年第17期105-109,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究阴式病灶切除联合子宫壁修补术治疗剖宫产瘢痕部位妊娠(CSP)的效果。方法:选择2019年1月—2022年1月在新泰市人民医院治疗的86例CSP患者作为研究对象,应用随机数表法分为对照组(子宫栓塞+清宫手术)及观察组(阴式病灶切除联合子宫壁修补术),各43例。比较两组临床指标[手术时间、术后阴道出血时间、术后β-人绒毛膜促性腺激素(β-hCG)恢复时间、住院时间]、卵巢储备功能指标[卵泡雌激素(FSH)、黄体生成素(LH)、雌二醇(E_(2))、β-hCG]、应激指标[促肾上腺皮质激素(ACTH)、醛固酮(ALD)、皮质醇(Cor)]、子宫血流动力学指标[舒张末期血流速度(EDV)、阻力指数(RI)、收缩期峰值血流速度(PSV)、搏动指数(PI)、]及并发症发生率。结果:观察组手术时间长于对照组,术后阴道出血时间、术后β-hCG恢复时间、住院时间短于对照组,差异有统计学意义(P<0.05)。术前,两组卵巢储备功能指标、应激指标、子宫血流动力学指标比较,差异无统计学意义(P>0.05)。术后7 d,两组FSH、LH高于术前,E_(2)、β-hCG低于术前,但观察组FSH、LH、β-hCG低于对照组,E_(2)高于对照组,差异有统计学意义(P<0.05)。术后7 d,两组ACTH、ALD、Cor高于术前,但观察组低于对照组,差异有统计学意义(P<0.05)。术后3 d,两组EDV、RI、PSV、PI均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论:对CSP患者采用阴式病灶切除联合子宫壁修补术治疗,效果显著,手术应激反应较轻,对卵巢储备功能影响较小,可调节子宫血流动力学,降低并发症发生率。Objective:To explore the effect of vaginal lesion resection combined with uterine wall repair in the treatment of cesarean scar pregnancy(CSP).Method:A total of 86 pregnant patients with CSP treated in Xintai People's Hospital from January 2019 to January 2022 were selected as the study objects,and they were divided into control group(uterine embolization+uterine cleaning surgery)and observation group(vaginal lesion resection combined with uterine wall repair)by random number table method,with 43 cases in each group.The clinical indexes[surgery time,postoperative vaginal bleeding time,postoperativeβ-human chorionic gonadotropin(β-hCG)recovery time,hospitalization time],ovarian reserve function indexes[follicular estrogen(FSH),luteinizing hormone(LH),estradiol(E_(2)),β-hCG]and stress indexes[adrenocorticotropic hormone(ACTH),aldosterone(ALD),cortisol(Cor)],uterine hemodynamics indexes[end-diastolic blood flow velocity(EDV),resistance index(RI),peak systolic blood flow velocity(PSV),pulsation index(PI)]and complication rate between the two groups were compared.Result:The surgery time of the observation group was longer than that of the control group,and the postoperative vaginal bleeding time,postoperativeβ-hCG recovery time and hospitalization time were shorter than those of the control group,the differences were statistically significant(P<0.05).Before surgery,there were no significant differences in ovarian reserve function indexes,stress indexes and uterine hemodynamics indexes between the two groups(P>0.05).At 7 d after surgery,FSH and LH in two groups were higher than those before surgery,E_(2) andβ-hCG were lower than those before surgery,but FSH,LH andβ-hCG in observation group were lower than those in control group,E_(2) were higher than that in control group,the differences were statistically significant(P<0.05).At 7 d after surgery,ACTH,ALD and Cor in two groups were higher than those before surgery,but which in observation group were lower than those in control group,the differences were statistic

关 键 词：阴式病灶切除术 子宫壁修补术 剖宫产 子宫瘢痕妊娠 

分 类 号：R713.8[医药卫生—妇产科学]