两种不同术式治疗剖宫产子宫切口瘢痕妊娠的疗效及费用对比分析

Comparative analysis of efficacy and cost of two different surgical methods in the treatment of cesarean section incision scar pregnancy

目的:分析两种不同手术方式治疗剖宫产子宫切口瘢痕妊娠(CSP)的临床疗效与治疗费用。方法:2018年2月-2019年11月收治CSP患者80例,按手术方式不同将分为两组。对照组采用双侧动脉介入栓塞术+清宫术治疗;观察组采用阴式子宫切口妊娠瘢痕病灶清除术+子宫修补术治疗。比较两组患者临床疗效及治疗费用。结果:观察组手术时间、术中出血量、住院时间及治疗费用均显著低于对照组,差异有统计学意义(P<0.05);观察组平均月经复潮时间早于对照组,并发症发生率低于对照组,差异有统计学意义(P<0.05);观察组术后24 h体温低于对照组,抗生素药物应用时间及血人绒毛膜促性腺激素(β-HCG)水平恢复正常时间均短于对照组,差异有统计学意义(P<0.05)。结论:采取阴式子宫切口妊娠瘢痕病灶清除术+子宫修补术治疗CSP,可降低术中出血量、降低治疗费用,促进患者术后恢复,并发症发生率低,安全有效。

Objective:To analyze the clinical efficacy and cost of two different surgical methods in the treatment of cesarean section incision scar pregnancy(CSP).Methods:From February 2018 to November 2019,80 cases of CSP patients were enrolled,they were divided into two groups according to different surgical methods.The control group was treated with bilateral arterial interventional embolization+uterus curettage,while the observation group was treated with vaginal uterine incision scar pregnancy curettage+uterine repair.The clinical efficacy and cost of treatment between two groups were compared.Results:The operative time,amount of bleeding,length of hospital stays and treatment cost in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).The mean period of time to menstrual recovery in the observation group was earlier than that in the control group,the incidence rate of complications was lower than that of the control group,the differences were statistically significant(P<0.05).The body temperature of observation group was lower than that of control group 24 hours after operation,the antibiotic drug using time and blood human chorionic gonadotropin(β-HCG)level return to normal time were shorter than the control group,the differences were statistically significant(P<0.05).Conclusion:The implementation of vaginal uterine incision scar pregnancy curettage+uterine repair in for CSP patients can reduce the amount of bleeding,reduce the cost of treatment,promote the recovery of patients,the incidence rate of complications is low,it is also safe and effective.