两种不同手术方式治疗剖宫产疤痕妊娠的疗效观察

Observation of the efficacy of two different surgical methods on the treatment of cesarean scar pregnancy

目的探讨经腹疤痕妊娠物清除术与经阴道疤痕妊娠物清除术两种不同手术方式治疗剖宫产疤痕妊娠(CSP)的疗效,为临床提供参考。方法 60例CSP患者,随机分为对照组和观察组,各30例。对照组行经腹疤痕妊娠物清除术治疗,观察组行经阴道疤痕妊娠物清除术治疗。观察比较两组患者的一次手术治愈情况、相关指标、视觉模拟评分法(VAS)评分。结果两组患者一次手术治愈率均为100.00%(30/30),组间比较差异无统计学意义(P>0.05)。治疗后,观察组患者的手术时间、住院时间短于对照组,出血量少于对照组,差异具有统计学意义(t=7.676、8.410、27.897,P<0.05);两组患者的月经恢复时间、β-人绒毛膜促性腺激素(β-HCG)转阴时间比较差异无统计学意义(P>0.05)。术后24、48、72 h,观察组患者的VAS评分均低于对照组,差异具有统计学意义(P<0.05)。结论与经腹疤痕妊娠物清除术比较,经阴道疤痕妊娠物清除术治疗CSP的疗效较佳,可缩短手术时间、住院时间,减少出血量,减少并发症发生,缓解疼痛,值得推广。

Objective To investigate the efficacy of two different surgical methods of transabdominal scar pregnancy removal and transvaginal scar pregnancy removal on the treatment of cesarean scar pregnancy（CSP）, so as to provide reference for clinical practice. Methods A total of 60 CSP patients were randomly divided into control group and observation group, with 30 cases in each group. The control group received transabdominal scar pregnancy removal, and the observation group received transvaginal scar pregnancy removal. Observation and comparison were made on cure situation with one time operation, related index and visual analogue scale（VAS） score between the two groups. Results Both groups had cure rate with one time operation as 100.00%（30/30）, and the difference was not statistically significant（P〉0.05）. After treatment, the observation group had shorter operation time and hospitalization time than the control group, and less bleeding volume than the control group. Their difference was statistically significant（t=7.676, 8.410, 27.897, P〈0.05）. Both groups had no statistically significant difference in menstruation recovery time and β-human chorionic gonadotropin（β-HCG） negative-conversion time（P〉0.05）. In postoperative 24, 48 and 72 h, the observation group had lower VAS score than the control group, and the difference was statistically significant（P〈0.05）. Conclusion Compared with transabdominal scar pregnancy removal, transvaginal scar pregnancy removal shows better efficacy on the treatment of CSP, and it can shorten operation time, hospitalization time, reduce bleeding volume and occurrence of complications and relieve pain. It is worthy of promotion.