摘要
目的比较B超监测下清宫术与切开取胚术治疗内生型子宫瘢痕妊娠(CSP)的效果。方法回顾性分析78例内生型CSP患者的临床资料,按手术方式不同分为清宫术组47例和取胚术组31例。清宫术组在B超引导下行清宫术,取胚术组开腹或在腹腔镜下行切开子宫取胚术。比较两组术中出血量、手术时间、术后住院时间、住院费用、血β人绒毛膜促性腺激素(β-HCG)值降至正常所需时间、术后月经恢复正常所需时间及治疗效果。结果清宫术组术中出血量、手术时间及住院费用均少于取胚术组(均P <0. 05),两组术后住院时间、血β-HCG值降至正常所需时间及术后月经恢复正常所需时间及治疗成功率比较,差异均无统计学意义(均P> 0. 05)。结论 B超监测下清宫术与切开子宫取胚术治疗内生型CSP均安全有效,但B超监测下清宫术术中出血量、手术时间及住院费用少。
Objective To compare the efficacy between ultrasound-guided uterine curettage and incisional embryo removal in treating endogenous cesarean scar pregnancy( CSP). Methods Clinical data of 78 patients with endogenous CSP were retrospectively analyzed. The patients were divided into uterine curettage group( n = 47) or embryo removal group( n = 31) according to the operation method. The uterine curettage group underwent ultrasound-guided uterine curettage,while the embryo removal group underwent open or laparoscopic hysterotomy and embryo removal. The related indices were compared between the two groups,including intraoperative blood loss,operation time,postoperative hospital stay,hospitalization cost,duration for normalization of β human chorionic gonadotropin( β-HCG) level and menstruation after operation,and therapeutic effect. Results The intraoperative blood loss,operation time and hospitalization cost of the uterine curettage group were less than those of the embryo removal group( all P < 0. 05).There were no statistical differences in the postoperative hospital stay,or the duration for normalization of β-HCG level or menstruation after operation between the two groups( all P > 0. 05). Conclusion It is safe and effective to treat endogenous CSP by either ultrasound-guided uterine curettage or incisional embryo removal,however,ultrasound-guided uterine curettage obtains less intraoperative blood loss,operation time and hospitalization cost.
引文
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