阴式子宫瘢痕妊娠病灶清除术治疗剖宫产瘢痕部位妊娠的效果

Efficacy of transvaginal cesarean scar pregnancy debridement surgery in the treatment of pregnancy at cesarean section scar site pregnancy

目的:探讨阴式子宫瘢痕妊娠病灶清除术治疗剖宫产瘢痕部位妊娠的效果及对术中出血量、手术时间的影响。方法:选取2016年12月—2018年4月本院接收的28例剖宫产术后子宫切口瘢痕妊娠患者作为研究对象,采用随机数字表法分成观察组和对照组,每组14例。观察组采用阴式子宫瘢痕妊娠病灶清除术治疗,对照组采用肌注甲氨蝶呤+超声引导下清宫术治疗,对比两组患者的治疗效果。结果:观察组治愈率为100%,显著高于对照组的64.29%(P<0.05),观察组的术中出血量、β-人绒毛膜促性腺激素(β-HCG)恢复正常值时间以及住院时间均显著短于对照组(P<0.05);观察组手术时间长于对照组;观察组患的不良反应发生率为7.14%;显著少于对照组的42.86%(P<0.05)。结论:阴式子宫瘢痕妊娠病灶清除术治疗剖宫产瘢痕部位妊娠效果确切,应用价值较高,值得在临床推广使用。

Objective: To explore the effect of vaginal uterine scar removal in the treatment of pregnancy at the cesarean section scar site pregnancy and its influence on intraoperative blood loss and operation time.Methods:28 cases of pregnancy patients with cesarean section scar site pregnancy in our hospital from December 2016 to April 2018 as the research objects. They were divided into observation group and control group by random number table method, with 14 cases in each group.Observation group was treated with transvaginal cesarean scar pregnancy debridement surgery, and control group was treated with intramuscular injection of methotrexate + ultrasound-guided uterine evacuation, to compare the treatment effects of the two groups.Results:The cure rate in the observation group was 100%, which was significantly higher than 64. 29% in the control group. The difference was statistically significant(P<0. 05). The intraoperative blood loss, the time for β-HCG to return to normal and the length of hospital stay in the observation group were significantly shorter than those in the control group, and the difference was statistically significant(P<0. 05);The operation time of the observation group was longer than that of the control group(P<0. 05);The incidence of adverse reactions in the observation group was 7. 14%;it was significantly less than42. 86% in the control group, and the difference was statistically significant(P<0. 05).Conclusion:The transvaginal cesarean scar pregnancy debridement surgery has a definite effect on the treatment of cesarean section scar site pregnancy,it has high application value and is worthy of clinical promotion.