经阴道和腹腔镜两种方式治疗外生型子宫切口瘢痕妊娠的临床效果
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摘要
目的探究外生型子宫切口瘢痕妊娠采取不同术式治疗的疗效。方法选取2014年5月～2018年5月我院接收的60例外生型子宫切口瘢痕妊娠患者,随机分为对照组(n=30,采取腹腔镜下病灶切除术)与观察组(n=30,采取经阴道子宫下段病灶切除术),观察并对比两组手术相关指标及术后康复指标、并发症发生情况。结果观察组手术时间、治疗费用及术中出血量均较对照组明显要少(P <0.05);观察组肛门排气恢复时间、血β-hCG恢复正常时间及疼痛评分均对照组明显要低(P <0.05);两组并发症发生率比较差异无统计学意义(P> 0.05)。结论外生型子宫切口瘢痕妊娠采取经阴道下段病灶切除术治疗,创伤小,出血少,术后恢复快,费用低廉,能减轻患者的经济负担,具有推广价值。
Objective To study the curative effect of different surgical methods in exogenous uterine incision scar pregnancy. Methods Sixty patients with exogenous uterine incision scar pregnancy who were admitted to our hospital from May 2014 to May 2018 were selected.They were randomly divided into the control group(n=30,laparoscopic lesion resection)and the observation group(n=30,transvaginal lesion resection of lower segment of the uterus).The operation related indexes,postoperative rehabilitation indexes and occurrence of complications were observed and compared between two groups. Results Operation time,treatment costs and intraoperative blood loss in the observation group were significantly less than those in the control group(P < 0.05).Anal exhaust time,recovery time of β-hCG(β-human chorionic gonadotropin)and pain scores in the observation group were significantly lower than those in the control group(P < 0.05).There was no significant difference in the incidence of complications between two groups(P > 0.05). Conclusion Transvaginal lesion resection of lower segment of the uterus in treatment of exogenous uterine incision scar pregnancy has less trauma and blood loss,fast recovery and low costs.It can reduce the economic burden of patients,which is of value of promotion.
Objective To study the curative effect of different surgical methods in exogenous uterine incision scar pregnancy. Methods Sixty patients with exogenous uterine incision scar pregnancy who were admitted to our hospital from May 2014 to May 2018 were selected.They were randomly divided into the control group(n=30,laparoscopic lesion resection)and the observation group(n=30,transvaginal lesion resection of lower segment of the uterus).The operation related indexes,postoperative rehabilitation indexes and occurrence of complications were observed and compared between two groups. Results Operation time,treatment costs and intraoperative blood loss in the observation group were significantly less than those in the control group(P < 0.05).Anal exhaust time,recovery time of β-hCG(β-human chorionic gonadotropin)and pain scores in the observation group were significantly lower than those in the control group(P < 0.05).There was no significant difference in the incidence of complications between two groups(P > 0.05). Conclusion Transvaginal lesion resection of lower segment of the uterus in treatment of exogenous uterine incision scar pregnancy has less trauma and blood loss,fast recovery and low costs.It can reduce the economic burden of patients,which is of value of promotion.
引文
[1]徐萍萍,曹莉莉,阎萍,等.子宫切口瘢痕妊娠经阴道与腹腔镜手术治疗的临床疗效比较[J].东南国防医药,2016,18(6):594-596.
[2]Yazicioglu HF,Sevket O,Ekin M,et al.Incomplete healing of the uterine incision after cesarean section:Is it preventable by intraoperative digital dilatation of the internal cervical ostium?[J].Gynecologic and Obstetric Investigation,2012,74(2):131-135.
[3]陈玉阁,黄树峰,吴定康,等.经阴道和腹腔镜两种方式治疗外生型子宫切口瘢痕妊娠的临床效果[J].重庆医学,2018,47(15):2048-2050.
[4]李梅,杨素芬,毛红霞,等.经阴道病灶切除术对剖宫产切口瘢痕妊娠的临床价值及文献分析[J].中国计划生育学杂志,2015,23(11):770-773.
[5]蒋清清,于鹏,谢红斌,等.宫腹腔镜联合手术治疗剖宫产子宫切口瘢痕缺陷[J].中国内镜杂志,2016,22(1):83-85.
[6]刘心.病灶清除术在经阴道剖宫产瘢痕妊娠与经腹腔镜剖宫产瘢痕妊娠中的疗效比较[J].实用临床医药杂志,2016,20(7):142,153.
[7]逯蓓蓓.剖宫产子宫瘢痕妊娠行MTX加清宫术、腹腔镜下病灶切除和经阴道病灶切除术的临床比较[J].泰山医学院学报,2017,38(3):317-318.
[8]Luthra G,Gawade P,Starikov R,et al.Uterine incisionto-delivery interval and perinatal outcomes in transverse versus vertical incisions in preterm cesarean deliveries[J].The Journal of Maternal-fetal&Neonatal Medicine,2013,26(18):1788-1791.
[9]王海燕,王红,许芙蓉,等.30例外生型子宫切口疤痕妊娠的临床探讨[J].实用临床医药杂志,2017,21(9):207-208.
[10]谢文阳,李萍,熊员焕,等.介入治疗、腹腔镜和经阴道3种途径在剖宫产切口瘢痕妊娠中的应用分析[J].生殖与避孕,2014,34(7):603-606,610.
[11]王淑丽,刘爱林,樊尊攀,等.经阴道彩色多普勒超声在子宫瘢痕妊娠早期诊治中的应用[J].中国妇幼保健,2015,30(17):2859-2860.
[12]郑丽君,江丽萍,何慧芳,等.经阴道子宫下段妊娠病灶切除术治疗外生型剖宫产瘢痕妊娠的临床研究[J].中国计划生育和妇产科,2017,9(1):72-75.
[13]徐杨,赵曼曼,东梅,等.三种方法治疗剖宫产术后子宫切口瘢痕妊娠42例临床疗效分析[J].海军医学杂志,2015,36(5):431-433.
[14]廖娅萍,谭毅,高莉,等.260例子宫切口瘢痕妊娠不同治疗方法的临床效果对比分析[J].第三军医大学学报,2016,38(8):901-904.
[15]钟小军.药物联合B超监视妇产科手术仪在剖宫产后瘢痕部位妊娠诊治中的作用探讨[J].中国生化药物杂志,2017,37(6):433-434.
[2]Yazicioglu HF,Sevket O,Ekin M,et al.Incomplete healing of the uterine incision after cesarean section:Is it preventable by intraoperative digital dilatation of the internal cervical ostium?[J].Gynecologic and Obstetric Investigation,2012,74(2):131-135.
[3]陈玉阁,黄树峰,吴定康,等.经阴道和腹腔镜两种方式治疗外生型子宫切口瘢痕妊娠的临床效果[J].重庆医学,2018,47(15):2048-2050.
[4]李梅,杨素芬,毛红霞,等.经阴道病灶切除术对剖宫产切口瘢痕妊娠的临床价值及文献分析[J].中国计划生育学杂志,2015,23(11):770-773.
[5]蒋清清,于鹏,谢红斌,等.宫腹腔镜联合手术治疗剖宫产子宫切口瘢痕缺陷[J].中国内镜杂志,2016,22(1):83-85.
[6]刘心.病灶清除术在经阴道剖宫产瘢痕妊娠与经腹腔镜剖宫产瘢痕妊娠中的疗效比较[J].实用临床医药杂志,2016,20(7):142,153.
[7]逯蓓蓓.剖宫产子宫瘢痕妊娠行MTX加清宫术、腹腔镜下病灶切除和经阴道病灶切除术的临床比较[J].泰山医学院学报,2017,38(3):317-318.
[8]Luthra G,Gawade P,Starikov R,et al.Uterine incisionto-delivery interval and perinatal outcomes in transverse versus vertical incisions in preterm cesarean deliveries[J].The Journal of Maternal-fetal&Neonatal Medicine,2013,26(18):1788-1791.
[9]王海燕,王红,许芙蓉,等.30例外生型子宫切口疤痕妊娠的临床探讨[J].实用临床医药杂志,2017,21(9):207-208.
[10]谢文阳,李萍,熊员焕,等.介入治疗、腹腔镜和经阴道3种途径在剖宫产切口瘢痕妊娠中的应用分析[J].生殖与避孕,2014,34(7):603-606,610.
[11]王淑丽,刘爱林,樊尊攀,等.经阴道彩色多普勒超声在子宫瘢痕妊娠早期诊治中的应用[J].中国妇幼保健,2015,30(17):2859-2860.
[12]郑丽君,江丽萍,何慧芳,等.经阴道子宫下段妊娠病灶切除术治疗外生型剖宫产瘢痕妊娠的临床研究[J].中国计划生育和妇产科,2017,9(1):72-75.
[13]徐杨,赵曼曼,东梅,等.三种方法治疗剖宫产术后子宫切口瘢痕妊娠42例临床疗效分析[J].海军医学杂志,2015,36(5):431-433.
[14]廖娅萍,谭毅,高莉,等.260例子宫切口瘢痕妊娠不同治疗方法的临床效果对比分析[J].第三军医大学学报,2016,38(8):901-904.
[15]钟小军.药物联合B超监视妇产科手术仪在剖宫产后瘢痕部位妊娠诊治中的作用探讨[J].中国生化药物杂志,2017,37(6):433-434.