阴式子宫瘢痕妊娠病灶清除术临床分析

Clinical analysis on transvaginal cesarean scar pregnancy debridement surgery

目的:探讨子宫瘢痕妊娠(CSP)经阴道病灶切除术的可行性、安全性和疗效。方法:回顾性分析2012年2月—2013年12月17例子宫瘢痕妊娠患者的资料,分析临床一般资料、围术期资料、术后HCG下降情况及月经复潮时间。结果:17例患者行阴道彩超确诊,直接行阴式子宫瘢痕妊娠病灶清除术均获成功,无并发症发生,手术时间(32.5±10.6)min,术中出血量(50.5±30.5)mL,住院天数(7.3±2.6)d,住院费用(8 130±1 250)元,术后血HCG恢复正常时间(15.5±7.5)d,月经复潮时间(26.7±2.1)d。结论:阴式子宫瘢痕妊娠病灶清除术可直接彻底清除病灶,具有手术时间短、出血少、术后恢复快及并发症少等优点,有一定阴式手术经验者即可开展,是治疗CSP的一种安全可行的术式。

Objective： To evaluate feasibility,efficacy and safety of transvaginal cesarean scar pregnancy（ CSP） debridement surgery. Methods： A total of 17 patients with cesarean scar pregnancy were recruited and retrospectively analyzed from the materal and children＇s Hospital of Jiujiang from December 2012 to January 2013,baseline characteristics,perioperative data,postoperative human chorionic gonadotropin（ HCG）,time of menstruation. Results： All 17 patients had routine vaginal colour to exceed diagnose,direct scar pregnancy vaginal hysterectomy for removal of lesions,17 cases were successful,no complications occurred,mean operation time was（ 32. 5 ± 10. 6） min,mean blood bleeding during operation was（ 50. 5 ± 30. 5） mL,mean admission time was（ 7. 3 ± 2. 6） d. The mean hospitalization cost was（ 8 130 ± 1 250） yuan,mean recovery time of blood HCG levels was（ 15. 5 ± 7. 5） d,mean recovery of menstruation after operation was（ 26. 7 ± 2. 1） d. Conculsion： Transvaginal cesarean section incision scar pregnancy for removal of lesions can be directly eradicate lesions,with shorter operation time,less bleeding,rapid recovery and less complications. It was safe and feasible surgery for the treatment of CSP and worth clinical promotion for doctors with transvaginal operation experience.