摘要
目的探讨本院26例剖宫产瘢痕妊娠(CSP)宫腹腔镜联合治疗的临床效果和安全性。方法回顾性分析2018年1月-2018年12月本科室收治的经宫腹腔镜联合治疗的26例剖宫产瘢痕妊娠患者的临床资料,其中内生型16例(Ⅰ型3例,Ⅱ型13例),外生型10例(Ⅱ型4例,Ⅲ型6例),手术方法:依据患者情况采用备腹腔镜的宫腔镜检查+清宫术、腹腔镜监视下宫腔镜下妊娠病灶电切术、腹腔镜下双侧子宫动脉阻断术+妊娠病灶切除+子宫修补术+宫腔镜检查术。结果研备腹腔镜的宫腔镜检查+清宫术6例,腹腔镜监视下宫腔镜下妊娠病灶电切术8例,腹腔镜下双侧子宫动脉阻断术+妊娠病灶切除+子宫修补术+宫腔镜检查术12例。26例患者术后查血β-hCG,均于术后(2~4)周降至正常(6例2周降至正常,20例4周降至正常),电话随访所有患者月经均于术后(4~6)周恢复。结论术前对剖宫产瘢痕妊娠进行准确分型,根据具体情况选择合适的手术方式,宫腹腔镜联合手术具有创伤小、出血少、恢复快、修复子宫憩室、减少再发风险,临床效果安全有效。
Objective To investigate the clinical efficacy and safety of laparoscopic combined treatment of 76 cases of cesarean section scar pregnancy(CSP)in our hospital.Methods The clinical data of 26 patients with cesarean scar pregnancy treated by laparoscopic laparoscopic treatment from January 20 to December 2018 in our department were retrospectively analyzed.Among them,16 were endogenous(3 cases of type Ⅰ,Ⅱ13 cases),10 cases of exogenous type(4 cases of type Ⅱ,6 cases of type Ⅲ),surgical methods:according to the patient's condition,hysteroscopy with laparoscopic surgery and hysteroscopy,laparoscopic monitoring of hysteroscopic pregnancy Lesion resection,laparoscopic bilateral uterine artery occlusion+pregnancy resection,uterine repair,hysteroscopy.Results Laparoscopic hysteroscopy and uterine hysterectomy in 6 cases,laparoscopic hysteroscopic resection of 8 cases of gestational lesions,laparoscopic bilateral uterine artery occlusion,pregnancy resection,uterine repair of hysteroscopy were 12 cases.All the 26 patients showed normal blood beta hCG at 2-4 weeks after the operation(6 patients showed normal at 2-week and 20 patients showed normal at 4-week),and all the patients'menstruation recovered at 4-6 weeks after the operation.Conclusion Accurate classification of cesarean section scar pregnancy before surgery,according to the specific circumstances to choose the appropriate surgical approach,laparoscopic combined surgery has less trauma,less bleeding,quick recovery,repair uterine diverticulum,reduce the risk of recurrence,clinical effect Safe and effective.
作者
郝爽
HAO Shuang(Department of Urology,The First Jikun Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830000,China)
出处
《新疆医学》
2019年第9期878-881,共4页
Xinjiang Medical Journal
关键词
瘢痕妊娠
剖宫产
宫腔镜
腹腔镜
Scar Pregnancy
Cesarean Section
Hysteroscopy
Laparoscopy
