宫腹腔镜联合手术治疗Ⅲ型剖宫产瘢痕妊娠的临床价值

Clinical value of combined hysteroscopic and laparoscopic surgery in the treatment of typeⅢcaesarean scar pregnancy

目的探析宫腹腔镜联合手术治疗Ⅲ型剖宫产瘢痕妊娠的临床价值。方法选取92例Ⅲ型剖宫产瘢痕妊娠患者为研究对象,采用随机数字表法将其分为常规组(46例,行传统经阴道病灶切除手术结合子宫瘢痕修复治疗)与实验组(46例,行宫腹腔镜病灶切除术结合子宫瘢痕修复治疗)。对比两组患者手术相关指标、术后恢复指标、并发症发生率及治疗效果。结果实验组患者的手术时间长于常规组,术中阴道出血量少于常规组,术后的唤醒睁眼时间、清醒时间、定向力恢复时间短于常规组,差异具有统计学意义(P<0.05)。实验组患者术后的住院时间、月经恢复时间、血β-人绒毛膜促性腺激素(β-HCG)恢复正常时间短于常规组,差异具有统计学意义(P<0.05)。实验组患者并发症发生率10.87%低于常规组的28.26%,差异具有统计学意义(P<0.05)。实验组患者治疗有效率为95.65%,高于常规组的73.91%,差异具有统计学意义(P<0.05)。结论使用宫腹腔镜联合手术治疗Ⅲ型剖宫产瘢痕妊娠的手术时间虽然较长,但术中阴道出血量少、手术安全性更高,并在提高手术治疗效果的同时促进患者术后身体各项机能的恢复,有效降低术后并发症发生率,提高患者的预后效果,具有较高的临床应用价值,可进一步在临床中推广与普及。

Objective To explore the clinical value of combined hysteroscopic and laparoscopic surgery in the treatment of typeⅢcaesarean scar pregnancy.Methods A total of 92 patients with typeⅢcaesarean scar pregnancy were selected as the study subjects,and were divided into a conventional group(46 cases,traditional transvaginal lesion resection combined with repair of uterine scar)and an experimental group(46 cases,hysteroscopic and laparoscopic lesion resection combined with repair of uterine scar)by random number table method.The surgical related indicators,postoperative recovery indicators,incidence of complications and treatment effect were compared between the two groups.Results In the experimental group,the operation time was longer than those of the conventional group;the amount of intraoperative vaginal bleeding was less than those of the conventional group;the postoperative arousal and eye-opening time,the awake time,and the orientation recovery time was shorter than those of the conventional group.The difference was statistically significant(P<0.05).The postoperative hospital stay,menstrual recovery time and bloodβhuman chorionic gonadotrophin(β-HCG)recovery time of the experimental group was shorter than those of the conventional group.The difference was statistically significant(P<0.05).The incidence of complications of 10.87%in the experimental group was lower than 28.26%in the conventional group,and the difference was statistically significant(P<0.05).The effective rate of treatment of 95.65%in the experimental group was higher than 73.91%in the conventional group,and the difference was statistically significant(P<0.05).Conclusion Although the surgical time for the treatment of typeⅢcaesarean scar pregnancy using combined hysteroscopic and laparoscopic surgery is longer,the intraoperative vaginal bleeding is less,the surgical safety is higher,and it promotes the recovery of the patients'postoperative body functions while improving the surgical treatment effect,effectively reduces the incidence of postoperative complications,and improves the prognosis of the patients.It is of high clinical value,and can be further popularized and promoted in the clinic.