宫腔镜手术治疗剖宫产术后子宫瘢痕妊娠的临床效果观察

Observation on Clinical Effect of Hysteroscopic Surgery in Treatment of Cesarean Scar Pregnancy after the Cesarean Section Surgery

目的对宫腔镜手术治疗剖宫产术后子宫瘢痕妊娠的临床效果进行分析。方法收集该院2014年6月—2016年6月剖宫产术后子宫瘢痕妊娠患者50例随机分两组,每组25例。常规治疗组采用药物联合清宫术进行治疗,宫腔镜手术组应用宫腔镜手术治疗。比较两组患者剖宫产术后子宫瘢痕妊娠治疗满意率;平均手术时间、平均住院时间、手术流血量、术后首次月经时间、术后β人绒毛膜促性腺激素复常时间;治疗前和治疗后患者生活质量评分的差异。结果宫腔镜手术组患者剖宫产术后子宫瘢痕妊娠治疗满意率96.00%高于常规治疗组76.00%(P<0.05);宫腔镜手术组平均手术时间、平均住院时间、手术流血量、术后首次月经时间、术后β人绒毛膜促性腺激素复常时间(28.51±1.41)min、(5.13±1.13)d、(65.62±6.21)mL、(39.51±4.41)d、(15.51±2.62)d优于常规治疗组(40.39±2.77)min、(7.78±3.13)d、(106.61±12.59)mL、(62.39±4.45)d、(33.39±3.51)d(P<0.05),治疗前两组生活质量评分比较差异无统计学意义(P>0.05);治疗后宫腔镜手术组生活质量评分改善幅度更大(P<0.05)。结论宫腔镜手术治疗剖宫产术后子宫瘢痕妊娠的临床效果确切,可缩短手术时间,减少流血量,加速术后月经和β人绒毛膜促性腺激素恢复,缩短患者住院时间,提升生活质量,值得推广。

Objective To analyze the clinical effect of hysteroscopic surgery in treatment of cesarean scar pregnancy after the cesarean section surgery. Methods 50 cases of patients with cesarean scar pregnancy after the cesarean section in our hospital from June 2014 to June 2016 were selected and randomly divided into two groups with 25 cases in each, the routine treatment group were treated with drugs and dilatation and curettage, while the hysteroscopic surgery group were treated with hysteroscopic surgery, and the satisfactoy rate, average operation time, average length of stay, operation bleeding amount, first menstruation time alter operation and HCG reeovery time after operation were compared between the two groups, and the difference in the quality of life before and after treatment was compared. Results The treatment satistactory rate was higher than that of routine treatment group （96.00% vs 76.00%）（P〈0.05）, and the average operation time, average lengthoof stay, operation bleeding amount,first menstruation time after operation and HCG reeovel3 time after operation were better than those in the routine treatment group[（28.51±1.41 ）min,（5.13±1.13）d, （65.62±6.21）mL, （39.51± 4.41 ）d, （ 15.51 ±2.62 ） d vs （40.39±2.77）min, （7.78±3.13 ）d, （ 106.61 ±12.59 ） mL, （62.39±4.45）d, （33.39±3.51 ）d] （ P〈0.05 ）, and there was no obvious difference in the quality of life score between the two groups before treatment （P〉0.05）, alter treatment, the quality of life score in the hysteroscopic surgery was bigger （P〈0.05）. Conclusion The clinical effect of hysteroscopic surgery in treatment of ee-sarean scar pregnancy after the cesarean section surgery is definite, which can shorten the operation time, reduce the bleeding amount, accelerate the postoperative recovery of menstruation and HCG, shorten the length of stay and improve the quality of life, and it is worth promotion.