介入治疗联合宫腔镜下电切术在剖宫产术后子宫瘢痕妊娠中的应用效果及对住院时间、安全性的影响

The effect of interventional therapy combined with hysteroscopic resection in uterine scar pregnancy after cesarean section and its influence on hospitalization time and safety

目的分析子宫瘢痕妊娠应用介入治疗联合宫腔镜下电切术的临床效果、住院时间及安全性。方法 104例剖宫产术后子宫瘢痕妊娠患者,采用随机数字表法分为对照组和观察组,每组52例。对照组应用清宫术治疗,观察组应用介入治疗联合宫腔镜下电切术治疗。比较两组患者的治愈率、阴道出血量、β-人绒毛膜促性腺激素(β-HCG)转阴时间、并发症发生情况及住院时间。结果观察组患者治愈48例,治愈率为92.31%;对照组患者治愈37例,治愈率为71.15%。观察组患者治愈率高于对照组,差异具有统计学意义(P<0.05)。观察组患者β-HCG转阴时间短于对照组,阴道出血量少于对照组,差异具有统计学意义(P<0.05)。观察组患者住院时间为(3.00±0.64)d,短于对照组的(8.96±1.76)d,差异具有统计学意义(P<0.05)。观察组患者并发症发生率为7.69%,低于对照组的23.08%,差异具有统计学意义(P<0.05)。结论介入治疗联合宫腔镜下电切术治疗剖宫产术后子宫瘢痕妊娠的效果显著,且住院时间短,安全性高,值得临床推广应用。

Objective To analyze the effect of interventional therapy combined with hysteroscopic resection in uterine scar pregnancy after cesarean section and its influence on hospitalization time and safety.Methods A total of 104 cases of uterine scar pregnancy after cesarean section were divided into control group and observation group according to random numerical table,with 52 cases in each group.The control group was treated with uterine evacuation,and observation group was treated with interventional therapy combined with hysteroscopic resection.The cure rate,amount of vaginal bleeding,β-human chorionic gonadotropin(β-HCG)negative-conversion time,occurrence of complications and hospitalization time were compared between the two groups.Results In the observation group,48 cases were cured,the cure rate was 92.31%;in the control group,37 cases were cured,the cure rate was 71.15%.The cure rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Theβ-HCG negative-conversion time of the observation group was shorter than that of the control group,and amount of vaginal bleeding was less than that of the control group.The difference was statistically significant(P<0.05).The hospitalization time of the observation group was(3.00±0.64)d,which was shorter than(8.96±1.76)d of the control group,and the difference was statistically significant(P<0.05).The incidence of complications of the observation group was 7.69%,which was lower than 23.08%of the control group,and the difference was statistically significant(P<0.05).Conclusion Interventional therapy combined with hysteroscopic resection shows remarkable effect on uterine scar pregnancy after cesarean section with short hospitalization time and high safety,which is worthy of clinical promotion and application.