腹腔镜与经阴道子宫瘢痕妊娠病灶切除术治疗外生型剖宫产瘢痕妊娠效果观察

Effect of laparoscopic and transvaginal excision of lesion in cearean scar pregnancy on xogenous cesarean scar pregnancy

目的探讨腹腔镜与经阴道子宫瘢痕妊娠病灶切除术治疗外生型剖宫产瘢痕妊娠的临床效果。方法选择外生型剖宫产子宫瘢痕妊娠（CSP）患者53例，按手术方法分为两组，腹腔镜组28例，行腹腔镜子宫瘢痕妊娠病灶切除术；阴式组25例，行经阴道子宫瘢痕妊娠病灶切除术。结果两组术中出血量、手术时间、住院时间比较差异未见统计学意义（P〉0．05）；腹腔镜组住院费用高于经阴道组，差异有统计学意义（P〈0．05）。两组患者肛门排气时间、血人绒毛膜促性腺激素（HCG）恢复至正常水平的时间、月经来潮时间、病灶消失时间比较差异未见统计学意义（P〉0．05）。结论腹腔镜及经阴道子宫瘢痕妊娠病灶切除术均是微创治疗外生型剖宫产瘢痕妊娠的方法，应根据术者的经验、手术技巧的掌握程度及患者的具体情况来选择。

Objective To investigate the clinical effect of laparoscopic and transvaginal excision of lesion in cesarean scar pregnancy （CSP） on exogenous CSP. Methods Fifty-three patients with exogenous CSP were divided into laparoscopy group （n = 28） and transvaginal surgery group （n = 25） according to surgi- cal procedures; patients in laparoscopy group were trearted by laparoscopic CSP lesion excision, and patients in tansvaginal surgery group were treated by transvaginal CSP lesion excision. Results The operation time, intraoperative blood loss and hospital stay of two groups were similar （P 〉 0. 05）. However, hospital expense in laparoscopy group was higher than that in transvaginal sugery group, the difference was significant （P 〈 0. 05 ）. The differences of first flatus time after operation, time of human chorionic gonadotropin （HCG） retur- ning to normal levels, menstrual cycle and lesion reduction time of the two groups were not statistically signifi- cant （P 〉0. 05）. Conclusions Laparoscopic and transvaginal CSP lesion excision both are minimally in- vasive treatment for exogenous CSP. The methods of treatment and the operative route mainly depend on the experience, surgical skills and particular case of patients.