阴式病灶清除术与腹式病灶清除术治疗剖宫产瘢痕部位妊娠的临床分析

Clinical Analysis of Transvaginal Focal Cleaning and Transabdominal Focal Cleaning in the Treatment of Caesarean Scar Pregnancy

目的:探讨阴式病灶清除术治疗剖宫产瘢痕部位妊娠的应用价值。方法:选取笔者所在医院2009年1月-2014年8月收治的40例CSP患者作为研究对象,按照随机数字表法将其分为A组30例和B组10例。A组行阴式病灶清除+子宫修补术。B组行腹式病灶清除+子宫修补术。观察比较两组患者的术中出血量、手术时间、住院时间及术后第1天血h CG值。结果:所有患者均临床治愈,A组的术中出血量明显少于B组,手术时间、住院时间均明显短于B组,差异均有统计学意义(P<0.05)。两组的术后第1天血h CG值比较差异无统计学意义(P>0.05)。结论:阴式子宫病灶清除术安全有效、微创、手术过程简单、保留了子宫和生育能力,是剖宫产瘢痕部位妊娠的最佳手术治疗方法。

Objective：To investigate the application value of transvaginal focal cleaning in the treatment of caesarean scar pregnancy. Method：40 patients with caesarean scar pregnancy in our hospital from January 2009 to August 2014 were selected as research subjects,they were divided into the group A for 30 cases and the group B for 10 cases according to the random number table method.The group A underwent transvaginal focal cleaning and uterus neoplasty.The group B underwent transabdominal focal cleaning and uterus neoplasty.The intraoperative blood loss,surgery time, length of hospital stay and serum hCG price in the first day postoperative in the two groups were observed and compared.Result：All cases were clinical cured.The intraoperative blood loss of the group A was significantly less than the group B,the surgery time and length of hospital stay in the group A were significantly shorter than the group B,the differences were statistically significant（P〈0.05）.There was no significantly different between the two groups in the serum hCG price in the first day postoperative（P〉0.05）.Conclusion：Transvaginal focal cleaning is safe and effective,minimally invasive,a simple operation procedure,which keeps uterus and fertility,is the best oprational method in caesarean scar pregnancy.