两种术式治疗剖宫产瘢痕妊娠的临床疗效比较

Comparison of two surgical methods in treating cesarean scar pregnancy

目的对比两种术式治疗剖宫产瘢痕妊娠的安全性、有效性。方法选取36例剖宫产瘢痕妊娠,分为研究组20例,实施腹腔镜瘢痕妊娠病灶切除术,对照组16例,实施阴式瘢痕妊娠病灶切除术。对两组患者术中出血、手术时间、肛门排气时间、住院时间、血HCG降至正常时间等指标进行比较。结果 36例患者手术均顺利完成,术中术后未发生严重并发症。两组患者术中出血、手术时间、住院时间等比较,差异有统计学意义(P<0.05);术后血HCG降至正常时间、肛门排气时间比较,差异无统计学意义(P>0.05)。结论腹腔镜瘢痕妊娠病灶切除术治疗剖产瘢痕妊娠具有安全、微创、恢复快及疗效肯定等优点,同时保留了患者的生育能力,值得临床推广应用。

Objective To investigate the safety and effectiveness of two surgical methods in treating cesarean scar pregnancy（CSP）. Methods From February 2010 to May 2013, 36 patients with CSP treated in the gynaecology and obstetrics department of the First affiliated hospital of guangxi medical university were analyzed retrospectively. 20 patients undergoing laparoscopic surgery were assigned to the research group, while 16 patients undergoing transvaginal cesarean scar pregnancy debridement surgery were assigned to the control group. The following clinical parameters were compared, including intraoperative blood loss, the time for operation, post-operation anus ventilate, hospital and recovery of blood HCG levels. Results Surgery was successfully completed in all 36 cases without serious intraoperative and postoperative complications. Significant differences were found in intraoperative blood loss, operation time and hospital time （P 〈 0. 05 ）, while there were no significant differences in the time of the serum level of β-hCG needed to return to normal level and anus ventilate （ P 〉 0.05 ）. Conclusion Laparoscopic surgery in treating with CSP offers the advantages of safety, minimally invasiveness, prompt recover, good effects, and the conservation of the fertility potential, worthy promotion.