经阴道手术对产妇剖宫产后子宫瘢痕妊娠的应用实效性及安全性探究

The Application Effectiveness and Safety Inquiry of Patients with Cesarean Section Scar Pregnancy Treated with Vaginal Surgery

目的：探讨经阴道手术对产妇剖宫产后子宫瘢痕妊娠（CSP）的应用实效性及安全性。方法：选取本院2011年1月-2013年8月确诊的30例剖宫产后子宫瘢痕妊娠孕妇，分成观察组及对照组，每组各15例，观察组患者进行阴道手术治疗，对照组患者进行药物治疗，对两组患者的疗效进行分析。结果：治疗后，观察组及对照组患者成功率分别为93.3%、66.7%，两组比较差异有统计学意义（χ2=6.282，P〈0.05）。治疗后，观察组及对照组患者的出血量、住院时间及β-hCG比较差异有统计学意义（P〈0.05）。30例CSP患者经过治疗后，24例患者能够完善的保留生育功能。在随访的过程中，观察组患者的血β-hCG值能够很快恢复到正常，对照组患者经过每周复查后，12例患者的血β-hCG值在出院后1~5周内能够恢复正常。25例患者在30~40 d内月经来潮，5例患者在40~60 d内月经来潮。结论：经阴道手术对子宫瘢痕妊娠患者进行治疗是一种较为适合的治疗方式，但是对于阴道狭窄、宫颈难以暴露的患者，应该根据实际情况，同时通过阴道超声检测及医师的手术经验，采取合理的治疗方案，为患者的康复提供保障。

Objective：To investigate the application effectiveness and safety inquiry of patients with cesarean section scar pregnancy treated with vaginal surgery. Method：30 cases of patients with cesarean section scar pregnancy were chosen from January 2011 to August 2013 in our hospital to received treatment,and divided into observation group and control group,15 patients in each group. The effects and complications were analyzed.Result：After treatment, analyzed the efficacy of observation group and the control group,the success rate was respectively 93.3%and 66.7%, after a comparative analysis,the difference was statistically significant（χ2=6.282,P〈0.05）.After treatment,analyzed after comparative analysis the amount of bleeding,length of stay andβ-hCG in the observation group and the control group of patients,the differences were statistically significant（P〈0.05）.30 cases of CSP patients after treatment,28 cases of patients were able to complete the preserve fertility. In the followed-up process,the bloodβ-hCG value of the observation group was able to quickly return to normal;the control group patients after the weekly review,bloodβ-hCG values in 12 patients 1-5 weeks after discharge can be restored normal. 25 patients were in the 30-40 d menstrual cramps, 5 patients were in the 40-60 d menstrual cramps.Conclusion：After vaginal surgery for the treatment of patients with caesarean section scar pregnancy is a more appropriate treatment,but for the patients of vaginal stenosis,cervical difficult to expose,should be based on the actual situation,through the vaginal ultrasound and surgical experience of physicians, to take reasonable treatment programs and provide protection for the rehabilitation of patients.