摘要
目的观察腹腔镜下暂时性子宫动脉结扎术治疗Ⅲ型子宫瘢痕妊娠的疗效。方法选择2016年1月至2018年5月河北医科大学第四医院收治的40例Ⅲ型子宫瘢痕妊娠患者为研究对象。将患者按手术方式分为观察组(n=17)和对照组(n=23)。对照组患者行子宫动脉介入栓塞术+腹腔镜下子宫瘢痕妊娠部位切除及修补术;观察组患者行腹腔镜下子宫动脉暂时性结扎术+子宫瘢痕妊娠部位切除及修补术。比较2组患者术中出血量、手术时间、住院时间、住院费用、术后体温恢复正常(降至37.3℃以下)时间、术后宫腔引流量、血清β-人绒毛膜促性腺激素(β-HCG)降至正常时间及术后月经恢复时间。结果2组患者均成功完成手术。2组患者术中出血量、术后β-HCG恢复正常时间、术后月经恢复时间、术后宫腔引流量比较差异均无统计学意义(P>0.05);观察组患者手术时间显著长于对照组(P<0.05),住院时间、术后体温恢复正常时间均显著短于对照组(P<0.05);观察组患者住院费用显著少于对照组(P<0.05)。对照组患者术后7例出现发热,5例出现不同程度的臀部疼痛,1例经血量较术前明显减少;观察组患者术后无明显不适。结论腹腔镜下暂时性子宫动脉结扎术治疗Ⅲ型子宫瘢痕妊娠疗效显著,可缩短患者住院时间及术后体温恢复正常时间,且术后并发症少。
Objective To investigate the efficacy of temporary uterine artery ligation under laparoscope in treatment of typeⅢcesarean scar pregnancy(CSP).Methods A total of 40 patients with typeⅢCSP admitted to the Fourth Hospital of Hebei Medical University from January 2016 to May 2018 were selected as research subjects,and they were divided into the observation group(n=17)and the control group(n=23)according to operation mode.The patients in the control group received uterine arterial embolism(UAE)and laparoscopic resection and repair of scar pregnancy site,while the patients in the observation group received temporary uterine artery ligation under laparosope and resection and repair of scar pregnancy site.The intraoperative blood loss,operation time,hospitalization stay,hospitalization cost,postoperative temperature return to normal time(falling below 37.3℃),postoperative intrauterine drainage,serumβ-human chorionic gonadotropin(β-HCG)decreased to normal stay and postoperative menstrual recovery time were compared between the two groups.Results The patients in the both groups were successfully completed the operation.There was no statistically significant difference in intraoperative blood loss,postoperativeβ-HCG return to normal time,postoperative menstrual recovery time,and postoperative uterine drainage between the two groups(P>0.05);the operation time in the observation group was significantly longer than that in the control group(P<0.05),the hospitalization stay and the postoperative body temperature return to normal time in the observation group were significantly shorter than those in the control group(P<0.05),and the hospitalization cost in the observation group was significantly less than that in the control group(P<0.05).In the control group,there were 7 cases of fever after operation,5 cases of hip pain of varying degrees,and 1 case of menstrual flow decreased significantly;and there was no obvious discomfort in the observation group.Conclusion Temporary uterine artery ligation under aparoscope has a significant therapeutic effeet on typeⅢCSP,which can shorten the hospitalization stay and the postoperative body temperature return to normal time,and with few postoperative complications.
作者
张海波
赵玮
马俊英
康山
ZHANG Haibo;ZHAO Wei;MA Junying;KANG Shan(Department of Gynaecology,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,Hebei Province,China)
出处
《新乡医学院学报》
CAS
2020年第9期865-868,共4页
Journal of Xinxiang Medical University
基金
河北省医学科学研究重点课题计划项目(编号:20201091)。
关键词
腹腔镜
子宫瘢痕妊娠
子宫动脉栓塞
laparoscope
cesarean scar pregnancy
uterine arterial embolism