腹腔镜及经阴道灶清除术治疗剖宫产瘢痕妊娠的效果比较

Removal of Laparoscopic and Transvaginal Focal Effects in the Treatment of Cesarean Scar Pregnancy Were Compared

目的比较腹腔镜及经阴道清除术治疗剖宫产瘢痕妊娠病灶效果。方法选取该院于2012年1月—2015年1月间收治的70例剖宫产瘢痕妊娠患者,根据其不同的手术方式将其分为观察组以及对照组,每组35例,其中对照组采取腹腔镜剖宫产瘢痕妊娠病灶清除术,观察组采用经阴道清除术,比较两组患者的手术时间、术中出血量、术后住院天数、住院费用及β-HCG恢复正常水平、月经恢复至正常水平所需时间,观察两组的并发症情况。结果两组患者术中出血量、术后血β-HCG降至正常所需时间已经术后月经恢复正常时间比较无明显差异,观察组的手术时间、术后住院天数、住院费用分别为(80.3±13.0)min,(3.3±0.2)d,(9 938.6±223.8)元,均明显少于对照组的(102.6±8.4)min,(4.6±0.3)d,(18 098.8±915.4)元,组间比较差异有统计学意义,P<0.05。两组中均无出现需中转开放病例,未出现膀胱、直肠损伤及其他术后并发症,术后未出现持续性异位妊娠。结论经阴道剖宫产瘢痕妊娠病灶清除手术以及腹腔镜方式均能够起到较好的临床疗效,而经阴道剖宫产瘢痕妊娠病灶清除手术更适用于基层医院。

Objective To compare laparoscopic and removal of vaginal lesions treatment of cesarean scar pregnancy.Selection Methods From January 2012 to January 2015, Our hospital 70 cases of cesarean scar pregnancy patients, according to its different operation, it can be divided into observation group and control group, each group of 35 cases,the control group take laparoscopic cesarean scar pregnancy for removal of lesion, removal of observation group used transvaginal, comparison of two groups of patients with operation time, intraoperative blood loss, postoperative hospitalization days, hospitalization expenses and beta HCG returned to normal level, menstrual time needed for recovery to normal levels, to observe the complications of two groups. Results Two groups of patients with intraoperative blood loss,postoperative blood beta HCG dropped to normal time has returned to normal after menstruation time required is no obvious difference, operation time, postoperative hospitalization days, hospitalization expenses in observation group were respectively(80.3 ± 13.0) min,(3.3±0.2) day,(9 938.6 ± 223.8) yuan, all significantly less than(102.6±8.4) min,(4.6±0.3) day,(18 098.8±915.4) yuan in the control group, difference between groups had statistical significance, P < 0.05.Would appear in the two groups had no transfer open cases, does not appear the bladder and rectum injury and other complications, no postoperative persistent ectopic pregnancy. Conclusion After cesarean scar pregnancy vaginal lesions cleared and laparoscopic surgery way can play a better clinical curative effect, and the vaginal lesions cleared cesarean scar pregnancy surgery is more suitable for basic-level hospitals.