摘要
目的探讨宫腔镜及宫腹腔镜联合手术对于Ⅱ型剖宫产瘢痕妊娠的临床治疗效果。方法收集中国医科大学附属盛京医院2013年2月至2016年1月确诊剖宫产瘢痕妊娠患者的临床资料,其中Ⅱ型患者共计58例,分为A组(行宫腔镜剖宫产瘢痕妊娠病灶切除术,n=36)和B组(行宫腹腔镜联合剖宫产瘢痕妊娠病灶切除术+子宫修补术,n=22)。比较2组患者手术情况、单次微创手术成功率、术后恢复情况以及再次妊娠结局。结果 A组手术时间[(26.6±4.9) min]明显短于B组[(63.2±8.3) min];A组出血量[(71.9±9.7) mL]明显低于B组[(80.3±8.2) mL];2组均无手术并发症发生;A组单次微创手术成功率(83.3%)与B组(86.4%)比较,无统计学差异;在月经恢复及术后血人绒毛膜促性腺激素(HCG)下降至正常范围时间方面,2组比较无统计学差异。结论宫腔镜及宫腹腔镜联合手术对于Ⅱ型剖宫产瘢痕妊娠均具有很好的治疗效果。
Objective To discuss the clinical effects of hysteroscopy and hysteroscopy combined with laparoscopy on typeⅡcesarean scar pregnancy( CSP). Methods We selected 58 patients diagnosed as having typeⅡCSP in Shengjing Hospital,China Medical University, between February 2013 and January 2016. Group A consisted of 36 patients who were treated with hysteroscopic CSP resection,while group B consisted of 22 patients treated with hysteroscopy combined with laparoscopic CSP resection and uterine repair. We compared the operation condition,single-operation success rate,postoperative recovery,and succeeding pregnancy outcome. Results The operation time in group A was 26.6±4.9 min,which was obviously shorter than that in group B. The bleeding volume in group A was 71.9±9.7 mL, which was obviously less than that in group B. No operation complication occurred in the two groups. The single-operation success rate was 83.3% in group A and 86.4% in group B,indicating no significant difference. No significant differences in menstruation recovery and the rate of decrease in human chorionic gonadotropin level to normal were found between groups A and B. Conclusion Both hysteroscopy and hysteroscopy combined with laparoscopy can be used to treat typeⅡcesarean scar pregnancy.
作者
张宁宁
杨清
ZHANG Ningning;YANG Qing(Department of Obstetrics and Gynecology,Shengjing Hospital,China Medical University,Shenyang 110004,China)
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2019年第1期58-61,共4页
Journal of China Medical University
基金
辽宁省科学事业公益研究基金(GY-2017-0017)
关键词
剖宫产
瘢痕妊娠
宫腔镜
腹腔镜
手术治疗
cesarean section
cesarean scar pregnancy
hysteroscopy
laparoscopy
surgical treatment
