宫腔镜手术对于不同临床分型早孕期剖宫产瘢痕妊娠的治疗效果

The Effect of Hysteroscopic Surgery on Cesarean Section Scar Pregnancy During Early Pregnancy with Different Clinical Types

目的分析不同临床分型早孕期剖宫产瘢痕妊娠患者行宫腔镜手术的治疗效果。方法选取2019年7月—2020年7月该院收治早孕期剖宫产瘢痕妊娠患者200例作为研究对象,根据患者临床分型将其分成3组,3组患者均行宫腔镜手术。观察患者手术指标、术后恢复时间、手术选择率和再次瘢痕妊娠发生率。结果A组患者的手术时间、术中出血量、阴道流血时间分别为(18.85±2.79)min、(21.67±1.89)mL、(8.74±1.12)d,B组患者的手术时间、术中出血量、阴道流血时间分别为(23.16±3.52)min、(70.33±3.13)mL、(8.49±1.03)d,C组患者的手术时间、术中出血量、阴道流血时间分别为(38.40±5.56)min、(78.25±3.91)mL、(9.10±1.36)d,A组患者手术时间和术中出血量优于B、C组患者,差异有统计学意义(P<0.05),3组患者阴道流血时间差异无统计学意义(P>0.05);3组患者月经恢复时间和血人绒毛膜促性腺激素(HCG)恢复时间差异无统计学意义(P>0.05),A组、B组、C组患者的超声影像恢复时间分别为(19.20±1.65)、(20.85±1.84)、(40.50±5.19)d,A、B组患者超声影像恢复时间优于C组患者,差异有统计学意义(P<0.05)。结论不同临床分型早孕期剖宫产瘢痕妊娠患者均可行宫腔镜手术治疗,效果明显,但Ⅲ型患者行宫腔镜手术难度大,临床上需酌情选择合理的手术方法,以获得更好的临床疗效。

Objective To analyze the therapeutic effect of hysteroscopic surgery in pregnant patients with cesarean section scars during early pregnancy with different clinical types.Methods From July 2019 to July 2020,200 cases of cesarean scar pregnancy patients admitted to the hospital during early pregnancy were selected as the research objects,and they were divided into three groups according to the clinical classification of the patients.All three groups underwent hysteroscopic surgery.The surgical indicators,postoperative recovery time,surgical selection rate and incidence of re-scarring pregnancy were observed in the three groups of patients.Results Operation time,intraoperative blood loss,and vaginal bleeding time of group A patients were(18.85±2.79)min,(21.67±1.89)mL,(8.74±1.12)d,group B patients'operation time,intraoperative bleeding and vaginal bleeding time were(23.16±3.52)min、(70.33±3.13)mL、(8.49±1.03)d,respectively.Operation time,intraoperative bleeding and vaginal bleeding time of group C patients respectively(38.40±5.56)min、(78.25±3.91)mL、(9.10±1.36)d.The operation time and intraoperative blood loss in group A were better than those in group B and group C,the difference was statistically significant(P<0.05).There was no statistically significant vaginal bleeding time in the three groups(P>0.05);there was no statistically significant difference in menstrual recovery time and blood HCG recovery time between the three groups(P>0.05).The ultrasound imaging recovery time of patients in group A,group B,and group C were(19.20±1.65)d,(20.85±1.84)d,(40.50±5.19)d,the ultrasound imaging recovery time of patients in group A and group B was better than that in group C,the difference was statistically significant(P<0.05).Conclusion Different clinical types of early pregnancy cesarean section scar pregnancy patients can be treated with hysteroscopic surgery,and the effect is obvious..