剖宫产切口疤痕妊娠40例结局分析

Outcome analysis in 40 Caesarean scar pregnancies

目的:探讨误诊对剖宫产术后疤痕妊娠结局的影响。方法:分析40例剖宫产切口疤痕妊娠的住院病历,初诊未诊断为疤痕妊娠的16例作为观察组,初诊确诊的24例作为对照组,对比分析两组患者入院前出血量、术前血β-HCG水平、住院时间、住院费用、术中出血量、休克发生率及并发症的差异。结果:观察组术前血β-HCG值(10 960.38±19 639.88)IU/L,与对照组(44 455.78±60 074.90)IU/L相比较,经秩和检验有统计学差异(P<0.05);与对照组相比较,观察组住院时间(11±7)d、入院前出血量观察组(平均秩为4.50)、术中出血量(395.00±708.98)mL及住院费用(11 260.86±7 750.07)元,经秩和检验无统计学差异(P>0.05);观察组休克发生率(14.29%)与对照组(4.35%),经卡方检验无统计学差异(P>0.05);两组均未出现子宫破裂及腹腔大出血。结论:剖宫产切口疤痕妊娠患者经积极处理多能避免严重并发症子宫破裂及腹腔大出血的发生。

Aim：To investigate the outcomes of the misdiagnosis of cesarean scar pregnancies.Meth-ods：Analysis of 40 cesarean scar pregnancies medical records,1 6 cases of first undiagnosed as scar pregnancy in the observation group,24 cases of first diagnosed as scar pregnancy in the control group, comparative analysis of the differences between the two groups patients about the amount of bleeding be-fore admission,preoperative blood β-HCG levels,hospitalization time,hospital costs,intraoperative blood loss,the incidences and complications of shock.Results：The observation group preoperative ser-um β-HCG values （1 0 960.38 ±1 9 639.88 ）IU/L,compared with the control group （44 455.78 ± 60 074.90）IU/L,there was significantly difference compared by the rank sum test （P0.05 ）.Incidence of shock in the observation group （1 4.29%）and the control group （4.35%）,the chi-square test showed that there was no significant difference （P〉0.05 ）;uterine rupture and severe＆nbsp;bleeding were not occurred in the two groups.Conclusion：cesarean scar pregnancy after active treatment can avoid more serious complications such as uterine rupture and severe bleeding.