腹腔镜切开取胚术与超声监视下宫腔镜清宫术治疗剖宫产切口部妊娠的效果观察  

Observation on the effect of laparoscopic incision and embryo removal and hysteroscopic curettage under ultrasound monitoring in the treatment of cesarean scar pregnancy

作　　者：王伟霞 周亚静 赵杰 王彦坤 殷盈祥 WANG Weixia;ZHOU Yajing;ZHAO Jie;WANG Yankun;YIN Yingxiang(Department of Obstetrics and Gynecology,Laoling People's Hospital,Dezhou,Shandong 253600,China;Department of Gynecology,Qilu Hospital of Shandong University Dezhou Hospital,Dezhou,Shandong 253000,China;Department of Anesthesiology,Laoling People's Hospital,Dezhou,Shandong 253600,China;Headquarters,Laoling People's Hospital,Dezhou,Shandong 253600,China)

机构地区：[1]乐陵市人民医院妇产科,山东德州253600 [2]山东大学齐鲁医院德州医院妇科,山东德州253000 [3]乐陵市人民医院麻醉科,山东德州253600 [4]乐陵市人民医院院总部,山东德州253600

出　　处：《医药前沿》2025年第11期58-60,64,共4页Journal of Frontiers of Medicine

基　　金：山东省医药卫生科技项目(202305011713)。

摘　　要：目的观察腹腔镜切开取胚术与超声监视下宫腔镜清宫术治疗剖宫产切口部妊娠(CSP)的效果。方法择取2020年1月—2023年1月乐陵市人民医院收治的60例CSP患者,根据治疗方式不同分为观察组和对照组,每组30例。对照组实施腹腔镜切开取胚术,观察组实施超声监视下宫腔镜清宫术。比较两组卵巢功能指标[促卵泡生成素(FSH)、促黄体生成素(LH)、雌二醇(E2)、抗苗勒氏管激素(AMH)和泌乳素(PRL)]、手术相关指标和手术成功率。结果术后3个月,两组FSH、E2和AMH水平均升高,LH和PRL水平均降低,且观察组FSH、E2和AMH水平高于对照组,LH和PRL水平低于对照组;观察组术中出血量少于对照组,住院时间短于对照组,差异有统计学意义(P<0.05)。两组手术时间和手术成功率比较,差异无统计学意义(P>0.05)。结论CSP患者采用腹腔镜切开取胚术与超声监视下宫腔镜清宫术的手术效果相当,但后者更利于患者术后恢复及卵巢功能改善。Objective To observe the effect of laparoscopic incision and embryo removal and hysteroscopic curettage under ultrasound monitoring in the treatment of cesarean scar pregnancy(CSP).Methods A total of 60 CSP patients admitted to Laoling People's Hospital from January 2020 to January 2023 were selected and divided into observation group and control group according to different treatment methods,with 30 cases in each group.The control group was treated with laparoscopic incision and embryo removal,and the observation group was treated with hysteroscopic curettage under ultrasound monitoring.The ovarian function indexes[follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),anti-müllerian hormone(AMH)and prolactin(PRL)],operation related indexes and operation success rate were compared between the two groups.Results 3 months after operation,the levels of FSH,E2 and AMH in the two groups increased,while the levels of LH and PRL decreased.The levels of FSH,E2 and AMH in the observation group were higher than those in the control group,while the levels of LH and PRL were lower than those in the control group.The amount of bleeding in the observation group was less than that in the control group,and the hospitalization time was shorter than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in operation time and success rate between the two groups(P>0.05).Conclusions The effect of laparoscopic incision and embryo removal and hysteroscopic curettage under ultrasound monitoring in CSP patients is similar,but the latter is more conducive to postoperative recovery and improvement of ovarian function.

关 键 词：腹腔镜切开取胚术 宫腔镜清宫术 剖宫产切口部妊娠 促卵泡生成素 雌二醇 手术成功率 

分 类 号：R445[医药卫生—影像医学与核医学]