腹腔镜手术治疗剖宫产术后子宫瘢痕部位妊娠临床分析

Clinical analysis of laparoscopic surgery in the treatment of scarred uterus pregnancy after cesarean section

目的分析腹腔镜手术治疗剖宫产术后子宫瘢痕部位妊娠的效果。方法 31例腹腔镜手术治疗的剖宫产术后子宫瘢痕部位妊娠患者作为研究组。选取同期33例接受开腹手术治疗的剖宫产术后子宫瘢痕部位妊娠患者作为对照组,对比两组治疗效果及临床指标。结果研究组患者手术所用时间、术中出血量、住院时间、血β-人绒毛膜促性腺激素(HCG)水平恢复至正常时间及术后首次月经时间分别是(26.5±3.3)min、(63.2±7.6)ml、(5.4±1.7)d、(16.2±1.6)d及(41.1±4.6)d;对照组患者分别为(43.3±5.7)min、(106.4±16.5)ml、(8.5±2.1)d、(31.2±6.6)d及(62.8±9.2)d;研究组患者术中出血量少于对照组,手术所用时间、住院时间、血β-HCG水平恢复至正常时间及术后首次月经时间均短于对照组,差异有统计学意义(P<0.05)。结论腹腔镜手术治疗剖宫产术后子宫瘢痕部位妊娠更为安全、有效,能够缩短手术时间,减轻患者痛苦,保障母婴平安。

Objective To analyze effect by laparoscopic surgery in the treatment of scarred uterus pregnancy after cesarean section. Methods There were 31 patients with scarred uterus pregnancy after cesarean section in laparoscopic surgery as research group and 33 patients with scarred uterus pregnancy after cesarean section in laparotomy as control group. Comparison were made on treatment effect and clinical indexes in two groups. Results The research group had operation time, intraoperative bleeding volume, hospital stay time, recovery time of blood β-human chorionic gonadotropin, postoperative first menstruation time respectively as（26.5±3.3） min,（63.2±7.6） ml,（5.4±1.7） d,（16.2±1.6） d and（41.1±4.6） d, which were respectively（43.3±5.7） min,（106.4±16.5） ml,（8.5±2.1） d,（31.2±6.6） d and（62.8±9.2） d in the control group. The research group had less intraoperative bleeding volume and shorter operation time, hospital stay time, recovery time of blood β-human chorionic gonadotropin and postoperative first menstruation time than the control group. Their difference had statistical significance（P〈0.05）. Conclusion Laparoscopic surgery in treating scarred uterus pregnancy after cesarean section shows remarkable safety and effectiveness. It can shorten operation time, relieve pain in patients, and guarantee maternal and infantile safety.