宫腔镜手术在不同临床分型早孕期剖宫产瘢痕妊娠患者中的应用

Application of Hysteroscopic Surgery in Different Clinical Types of Early Pregnancy Cesarean Section Scar Pregnancy

目的:分析宫腔镜手术应用于不同临床分型早孕期剖宫产瘢痕妊娠患者治疗的临床效果。方法:以2017年3月~2019年3月收治的60例早孕期剖宫产瘢痕妊娠患者为研究对象,将患者分为Ⅰ型剖宫产妊娠瘢痕患者、Ⅱ型剖宫产妊娠瘢痕患者及Ⅲ型剖宫产瘢痕妊娠患者,分别编入A、B、C,三组,开展手术分析,分析三组患者的手术时间、术中出血量、术后出血持续时间、单次手术成功率与二次手术成功率。结果:Ⅲ型剖宫产瘢痕妊娠患者的手术时间高于其他两组,组间差异较为显著(P<0.05)。Ⅰ型剖宫产妊娠瘢痕患者的术中出血量低于其他两组患者,组间差异较为显著(P<0.05)。三组患者的术后阴道出血持续时间无明显差异(P>0.05)。Ⅰ型剖宫产妊娠瘢痕患者与Ⅱ型剖宫产妊娠瘢痕患者的一次手术成功率高于Ⅲ型剖宫产瘢痕妊娠者,组间差异较为显著(P<0.05);三组患者的二次手术成功率无明显差异(P>0.05)。结论:宫腔镜手术在不同临床分型早期孕期剖宫产瘢痕妊娠患者治疗中均具有一定的临床效果,此种手术方式更适用于Ⅰ型剖宫产妊娠瘢痕患者与Ⅱ型剖宫产妊娠瘢痕患者的治疗。

Objective:To analyze the clinical effect of hysteroscopy in the treatment of cesarean scar pregnancy with different clinical types.Methods:60 patients with early pregnancy cesarean scar pregnancy who were admitted in March 2017~March 2019 were divided into three groups:scar patients,scar patients and scar patients with scar patients with scar A,B,C,cesarean section and scar pregnancy patients with scar patients with scar during cesarean section and type III cesarean section respectively.Results:Type III cesarean section and the operation time of scar pregnancy patients was higher than that of the other two groups,and the difference between the two groups was significant(P<0.05).Compared with the other two groups,there was significant difference between the two groups(P<0.05).postoperative vaginal bleeding duration was not significantly different in the three groups(P>0.05).The success rate of one operation was higher in the patients with scar of caesarean section and scar of caesarean section than in the patients with scar of caesarean section of type III(P<0.05),and there was no significant difference in the success rate of secondary operation in the three groups(P>0.05).Conclusion:Hysteroscopic surgery has a certain clinical effect in the treatment of patients with cesarean scar pregnancy in early pregnancy of different clinical classifications.This type of surgery is more suitable for patients with cesarean pregnancy scars and type cesarean pregnancy Treatment of scar patients.