不同方式治疗剖宫产术后子宫疤痕妊娠的临床效果分析

Analysis on the Clinical Effects of Different Treatment Methods for Cesarean Scar Pregnancy After Cesarean Section

目的探讨不同方式治疗剖宫产术后子宫疤痕妊娠的疗效。方法选择我院2014年1月至2016年1月收治的剖宫产术后子宫疤痕妊娠患者120例,按照首治方案的不同将患者分为三组,其中A组为B超引导下清宫术,B组为阴式疤痕妊娠物清除术+疤痕修补术,C组为子宫动脉明胶海绵栓塞后行清宫术,比较三组的β-HCG水平、临床效果、住院时间以及住院费用。结果三组患者均完成手术治疗。三组患者在一次手术治疗成功率方面比较差异无统计学意义(P>0.05),术后3天三组的血清β-HCG下降程度比较差异无统计学意义(P>0.05);三组在入院时血清β-HCG水平、手术时间、术中出血量、住院时间、住院费用等方面比较,差异均有统计学意义(P<0.05)。结论治疗子宫疤痕妊娠患者时,需根据患者的孕囊与疤痕位置、疤痕厚度等综合考虑治疗方案,合理优化资源,在保障治疗效果的同时节省患者的住院费用。

Objective To explore the curative effects of different treatment methods for cesarean scar pregnancy （CS]？） after cesarean section. Methods 120 cases of patients with CSP after cesarean section admitted to our hospital from January 2014 to January 2016 were selected. According to the first treatment plan, all patients were divided into group A （B ultrasound-guided curettage）, group B （vaginal scar pregnancy removal ＋ scar repair） and group C （curettage after uterine arterial embolization with gelatin sponge）. The level of β-HCG, clinical effect, length of hospital stay and hospitalization expense were compared among three groups. Results All patients in the three groups completed surgery. No statistical difference was found among three groups in the success rate of one-time operation or decline degree of serum/3-HCG at 3 days after surgery （P 〉0.05）, while there were statistical differences among three groups in the serum β-HCG level at admission, operation time, intraoperative blood loss, length of hospital stay and hospitalization expenses （P 〈0.05）. Conclusions For patients with CSP after cesarean section, the treatment plan should be decided based on the location of pregnancy sac and scar, and the thickness of the scar, so as to optimize resource reasonably, guarantee treatment effect, as well as save patients＇ hospitalization expenses.