经阴道妊娠病灶切除术与腹腔镜下妊娠病灶切除术治疗Ⅱ、Ⅲ型剖宫产瘢痕妊娠临床效果对照研究

A comparative study of the clinical effect of transvaginal and laparoscopic foci resection in the treatment of typeⅡandⅢcesarean scar pregnancy

目的 探讨经阴道妊娠病灶切除术与腹腔镜下妊娠病灶切除术治疗Ⅱ、Ⅲ型妊娠的临床疗效。方法 选取自2017年1月至2023年1月收治的82例Ⅱ、Ⅲ型剖宫产瘢痕妊娠患者为研究对象。根据手术方法的不同分为阴式组(n=45,经阴道妊娠病灶切除术)与腹腔镜组(n=37,腹腔镜下妊娠病灶切除术),比较两组的治疗时间、术中出血量、术后月经恢复时间以及并发症的发生情况等。结果 阴式组患者的手术时间、住院时间、排气时间均明显短于腹腔镜组,术中出血量、住院费用明显少于腹腔镜组,差异有统计学意义(P<0.05)。两组患者的月经恢复时间比较,差异无统计学意义(P>0.05)。两组患者均成功完成手术,术后均未出现明显并发症。结论 经阴道妊娠病灶清除术与腹腔镜妊娠病灶清除术均为安全有效的手术方案,但经阴道妊娠病灶清除术的手术创伤小、恢复快、患者治疗负担低。

Objective To investigate the clinical effect of transvaginal focal resection of pregnancy and laparoscopic focal resection of pregnancy in the treatment of typeⅡandⅢcesarean scar pregnancy.Methods A total of 82 patients with typeⅡandⅢcesarean scar pregnancy from January 2017 to January 2023 were selected as subjects.According to the different surgical methods,they were divided into transvaginal group(n=45,transvaginal focal resection of pregnancy)and laparoscopic group(n=37,laparoscopic focal resection of pregnancy).The treatment time,intraoperative blood loss,postoperative menstrual recovery time and the occurrence of complications were compared between the two groups.Results The operation time,hospital stay and exhaust time of patients in the transvaginal group were significantly shorter than those in the laparoscopic group,and the intraoperative blood loss and hospital cost were significantly less than those in the laparoscopic group,with statistical significance(P<0.05).There was no significant difference in menstrual recovery time between the two groups(P>0.05).Both groups of patients successfully completed the operation,and no significant complications occurred after the operation.Conclusion Both transvaginal focal resection of pregnancy and laparoscopic focal resection of pregnancy are safe and effective surgical options,but transvaginal focal resection of pregnancy has less trauma,faster recovery and lower treatment burden.