医学临床研究
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医学临床研究  2020, Vol. 37 Issue (9): 1319-1322    DOI: 10.3969/j.issn.1671-7171.2020.09.013
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经阴道和宫腔镜下CSP病灶切除术治疗剖宫产术后子宫瘢痕妊娠不全流产的疗效比较
黄玮1, 马娜2
1.宝鸡市妇幼保健院妇科,陕西 宝鸡 721000;
2.延安市人民医院妇产科,陕西 延安 716000
Comparison of the Efficacy of Transvaginal and Hysteroscopic CSP Lesion Resection in the Treatment of Incomplete Abortion of Uterine Scar Pregnancy after Cesarean Section
HUANG Wei, MAN Na
Department of Gynecology, Baoji Maternal and Child Health Hospital, Baoji Shaanxi,721000
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摘要 【目的】 比较经阴道和宫腔镜下子宫瘢痕妊娠(scar pregnancy,CSP)病灶切除术治疗剖宫产术后CSP不全流产的疗效。【方法】 回顾性分析2014年1月至2019年1月在本院诊治的80例剖宫产术后CSP不全流产患者的临床资料,均于术前接受子宫动脉栓塞术,其中36例行经阴道CSP病灶切除+修补术(观察组),44例行宫腔镜下CSP病灶电切术(对照组)。比较两组中转开腹手术率、并发症、术中及术后相关指标。【结果】 两组患者均未发生膀胱损伤、经尿道前列腺电切术(TURP)综合征、子宫切除等严重并发症。对照组中转开腹手术率(22.7%)高于观察组(5.6%),其差异有统计学意义(P<0.05);两组宫腔感染率及腹痛程度比较差异无统计学意义(P>0.05);观察组术中平均出血量(105 mL)低于对照组(325 mL),其差异有统计学意义(P<0.05)。观察组一次手术成功率高于对照组,差异有统计学意义(P<0.05);术后阴道流血量低于对照组,术后阴道持续出血时间短于对照组,其差异有统计学意义(P<0.05)。观察组术后血绒毛膜促性腺激素(HCG)水平平均下降率高于对照组,差异有统计学意义(P<0.05)。两组手术时间及住院时间比较差异无统计学意义(P<0.05)。【结论】 与宫腔镜相比,经阴道CSP病灶切除手术术中出血少,手术成功率高、术后恢复快,可修补子宫瘢痕憩室,是治疗CSP不全流产的理想方法。
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作者相关文章
黄玮
马娜
关键词 剖宫产术/副作用妊娠,异位/外科学瘢痕宫腔镜检查    
Abstract【Objective】 To compare the efficacy of transvaginal and hysteroscopic resection of uterine scar pregnancy (CSP) for incomplete abortion after cesarean section.【Methods】 The clinical data of 80 patients with CSP incomplete abortion after cesarean section in our hospital from January 2014 to January 2019 were retrospectively analyzed. All patients received uterine artery embolization before operation, including 36 cases of transvaginal CSP lesion resection and repair (observation group), 44 cases of hysteroscopic CSP lesion resection (control group). The conversion rate, complications, intraoperative and postoperative indexes were compared between the two groups. 【Results】 No serious complications such as bladder injury, TURP syndrome and hysterectomy occurred in both groups. The conversion rate of the control group (22.7%) was higher than that of the observation group (5.6%), and the difference was statistically significant (P<0.05); there was no significant difference in the rate of intrauterine infection and abdominal pain between the two groups (P>0.05); the average intraoperative blood loss in the observation group (105 mL) was lower than that in the control group (325 ml), and the difference was statistically significant (P<0.05). The success rate of the first operation in the observation group was higher than that in the control group, the difference was statistically significant (P<0.05); the amount of postoperative vaginal bleeding was lower than that of the control group, and the duration of postoperative vaginal bleeding was shorter than that of the control group, the difference was statistically significant (P<0.05). The average decrease rate of HCG level in the observation group was higher than that in the control group (P<0.05). There was no significant difference in operation time and hospitalization time between the two groups (P<0.05). 【Conclusion】 Compared with hysteroscopy, transvaginal resection of CSP focus has the advantages of less bleeding, higher success rate, faster postoperative recovery, and repair of uterine scar diverticulum, which is an ideal method for the treatment of incomplete abortion of CSP.
Key wordsCesarean Section/AE    Pregnancy, Ectopic/SU    Cicatrix    Hysteroscopy
收稿日期: 2019-08-12     
PACS:  R719.8  
通讯作者: E-mail:huangwei_197306@163.com   
引用本文:   
黄玮, 马娜. 经阴道和宫腔镜下CSP病灶切除术治疗剖宫产术后子宫瘢痕妊娠不全流产的疗效比较[J]. 医学临床研究, 2020, 37(9): 1319-1322.
HUANG Wei, MAN Na. Comparison of the Efficacy of Transvaginal and Hysteroscopic CSP Lesion Resection in the Treatment of Incomplete Abortion of Uterine Scar Pregnancy after Cesarean Section. JOURNAL OF CLINICAL RESEARCH, 2020, 37(9): 1319-1322.
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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2020.09.013     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2020/V37/I9/1319
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