剖宫产术后子宫瘢痕妊娠85例临床分析

Clinical study on 85 cases with caesarean scar pregnancy

目的探讨腹腔镜手术治疗剖宫产术后子宫瘢痕妊娠(CSP)的可行性。方法回顾性分析2010年1月至2014年7月在青岛大学附属医院妇科收治的85例符合CSP诊断标准的患者的临床资料。其中45例行腹腔镜病灶清除术(腹腔镜组),40例行开腹病灶清除术(开腹组)。比较两组患者手术时间、术中出血量、手术后住院时间、术后血清β-hCG转为正常值的时间。结果腹腔镜组和开腹组患者手术均顺利完成。腹腔镜组手术时间、术中出血量、手术后住院时间均少于开腹组,差异有统计学意义(P<0.05),术后血清β-hCG转为正常值的时间两组间差异无统计学意义(P>0.05)。结论腹腔镜手术、开腹手术均可用于治疗CSP。腹腔镜手术治疗CSP具有术中出血少、住院时间短、恢复快等优点,值得推广。

Objective To investigate the feasibility of laparoscopic surgery on treatment of caesare- an scar pregnancy（CSP）. Methods From January 2010 to July 2014, 85 patients with CSP un- dergoing treatment in the Affiliated Hospital of Qingdao University were studied retrospectively. Forty-five patients were treated with laparoscopic surgery（laparoscopy group）, while forty pa- tients were treated by laparotomy（laparotomy group）. Operative time, intraoperative blood loss, postoperative hospitalization days, and the return of ]]-hCG to normal were compared between the two groups. Results Operation was all successfully completed in two groups. The operative time, intraoperative blood loss and postoperative hospitalization days of laparoscopy group were shorter than those of laparotomy group, the difference was statistically significant（P〈0.05）. The difference of the return of β-hCG to normal was not statistically significant between the two groups（P〉0.05）. Conclusion Both laparoscopic surgery and laparotomy can be used in the treatment of the CSP. Laparoscopic surgery could offer advantages including less blood loss, shorter hospitalization time and quick recovery. Laparoscopic surgery could be much more effec- tive in the treatment of CSP.