宫腹腔镜联合手术治疗子宫瘢痕妊娠的临床效果
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摘要
目的宫腹腔镜联合与清宫术治疗子宫瘢痕妊娠的效果比较。方法选择我院2015年2月～2018年3月收治的102例子宫瘢痕妊娠患者,采用电脑随机法将患者分为干预组和对照组,每组各51例。干预组接受宫腹腔镜联合手术,对照组接受传统清宫术治疗,评价两组术后并发症发生情况,评估手术及术后恢复各项指标。结果干预组手术时间、阴道流血时间、术后月经恢复正常时间、血β绒毛膜促性腺激素(β-HCG)恢复正常时间、住院时间均低于对照组(t=10.785、7.067、8.463、6.394、7.192,P<0.05),术中出血量少于对照组(t=6.235,P<0.05)。干预组并发症发生率为7.84%(4例),低于对照组的21.57%(11例)(χ~2=7.515,P<0.05)。结论与清宫术比较,宫腹腔镜联合手术治疗子宫瘢痕妊娠效果较好,手术时间短、术中出血量少、术后患者恢复快,并发症发生风险较低。
Objective To compare the efficacy of laparoscopic combined with uterine curettage in the treatment of uterine scar pregnancy. Methods A total of 102 patients with uterine scar pregnancy who admitted to our hospital from February 2015 t0 March 2018 were selected. They were equally divided into intervention group and control group by computer randomization, 51 cases in each group. In the intervention group, laparoscopic combined with surgery was adopted, while in the control group, traditional curettage was performed. The occurrence of postoperative complications of the two groups was evaluated. The time of various indexes returning to normal during and after surgery was evaluated. Results In the intervention group, the operation time, the time of vaginal bleeding, the time of menstruation returning to normal, the time of blood β-HCG returning to normal, and the hospital stay were lower than those of the control group(t=10.785, 7.067, 8.463, 6.394, 7.192; P<0.05), the amount of intraoperative blood loss was less than those of the control group(t=0.635, P<0.05). The incidence of complications in the intervention group was 7.84%(n=4), lower than that in the control group accounting for 21.57%(n=11)(χ~2=7.515, P<0.05). Conclusion Compared with uterine curettage, laparoscopic combined with surgery is effective in treating uterine scar pregnancy at advantages of short operation time, lower intraoperative blood loss, more favorable postoperative recovery effect, and lower risk of complications.
Objective To compare the efficacy of laparoscopic combined with uterine curettage in the treatment of uterine scar pregnancy. Methods A total of 102 patients with uterine scar pregnancy who admitted to our hospital from February 2015 t0 March 2018 were selected. They were equally divided into intervention group and control group by computer randomization, 51 cases in each group. In the intervention group, laparoscopic combined with surgery was adopted, while in the control group, traditional curettage was performed. The occurrence of postoperative complications of the two groups was evaluated. The time of various indexes returning to normal during and after surgery was evaluated. Results In the intervention group, the operation time, the time of vaginal bleeding, the time of menstruation returning to normal, the time of blood β-HCG returning to normal, and the hospital stay were lower than those of the control group(t=10.785, 7.067, 8.463, 6.394, 7.192; P<0.05), the amount of intraoperative blood loss was less than those of the control group(t=0.635, P<0.05). The incidence of complications in the intervention group was 7.84%(n=4), lower than that in the control group accounting for 21.57%(n=11)(χ~2=7.515, P<0.05). Conclusion Compared with uterine curettage, laparoscopic combined with surgery is effective in treating uterine scar pregnancy at advantages of short operation time, lower intraoperative blood loss, more favorable postoperative recovery effect, and lower risk of complications.
引文
[1]赵新玲,范造锋,白玉,等.宫腹腔镜治疗剖宫产瘢痕妊娠21例临床分析[J].中国微创外科杂志,2016,16(3):259-262.
[2]邢慧敏,梁军,耿晓,等.宫腹腔镜联合手术在剖宫产瘢痕妊娠治疗中的应用价值[J].解放军医药杂志,2016,28(9):90-92.
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[7]关芳.宫腔镜及宫腹腔镜联合治疗8例剖宫产瘢痕妊娠的临床分析[J].中国实用医药,2018,13(4):49-51.
[8]汪钰清,石晓燕,李琼,等.宫腔镜与腹腔镜联合应用治疗瘢痕妊娠的临床研究[J].中国妇幼健康研究,2017,28(3):343-345.
[9]陈晓霞.宫腹腔镜联合与子宫动脉栓塞治疗瘢痕部位妊娠比较[J].实用妇科内分泌电子杂志,2016,3(11):197-198.
[10]王醒,张红霞,田君,等.瘢痕妊娠3种治疗方法分析及再次妊娠结局[J].实用妇科内分泌电子杂志,2016,3(13):185-186.
[11]邹惠琼.宫、腹腔镜联合治疗瘢痕妊娠后子宫内膜恢复程度及远期妊娠观察[J].腹腔镜外科杂志,2017,22(12):952-955.
[12]陈向东,陈莉婷,柳晓春,等.两种子宫瘢痕妊娠手术方式的疗效及术后生活质量的比较[J].广东医学,2016,37(3):380-382.
[13]廖一名,李翠兰,莫薛唐,等.剖宫产子宫瘢痕妊娠62例临床分析[J].广东医学,2016,37(Z1):57-59.
[14]陈正云,李小永,赵达,等.宫腔镜手术终止早期Ⅱ型剖宫产术后子宫瘢痕妊娠的临床研究[J].中华妇产科杂志,2017,52(2):669-674.
[15]陈敏.腹腔镜下切除剖宫产瘢痕妊娠病灶的临床分析[J].中国内镜杂志,2016,22(6):104-106.
[16]秦万平,鲁菊英.宫腔镜、腹腔镜联合治疗子宫瘢痕妊娠的临床分析[J].临床医药文献电子杂志,2016,3(23):4589-4589,4592.
[2]邢慧敏,梁军,耿晓,等.宫腹腔镜联合手术在剖宫产瘢痕妊娠治疗中的应用价值[J].解放军医药杂志,2016,28(9):90-92.
[3]邵莉萍,陈琴,沈宗娣,等.宫腹腔镜治疗子宫瘢痕妊娠临床分析[J].徐州医学院学报,2016,36(3):168-170.
[4]马舒宁,赖微.宫腹腔镜联合与清宫术治疗子宫瘢痕妊娠的疗效对比分析[J].中国计划生育和妇产科杂志,2016,8(12):51-54.
[5]中华医学会妇产科学分会计划生育学组.剖宫产术后子宫瘢痕妊娠诊治专家共识(2016)[J].中华妇产科杂志,2016,51(8):568-572.
[6]闻捷,王晓燕,黄昊,等.宫腹腔镜联合与清宫术治疗子宫瘢痕妊娠的疗效分析[J].中国妇幼保健,2017,32(21):5472-5473.
[7]关芳.宫腔镜及宫腹腔镜联合治疗8例剖宫产瘢痕妊娠的临床分析[J].中国实用医药,2018,13(4):49-51.
[8]汪钰清,石晓燕,李琼,等.宫腔镜与腹腔镜联合应用治疗瘢痕妊娠的临床研究[J].中国妇幼健康研究,2017,28(3):343-345.
[9]陈晓霞.宫腹腔镜联合与子宫动脉栓塞治疗瘢痕部位妊娠比较[J].实用妇科内分泌电子杂志,2016,3(11):197-198.
[10]王醒,张红霞,田君,等.瘢痕妊娠3种治疗方法分析及再次妊娠结局[J].实用妇科内分泌电子杂志,2016,3(13):185-186.
[11]邹惠琼.宫、腹腔镜联合治疗瘢痕妊娠后子宫内膜恢复程度及远期妊娠观察[J].腹腔镜外科杂志,2017,22(12):952-955.
[12]陈向东,陈莉婷,柳晓春,等.两种子宫瘢痕妊娠手术方式的疗效及术后生活质量的比较[J].广东医学,2016,37(3):380-382.
[13]廖一名,李翠兰,莫薛唐,等.剖宫产子宫瘢痕妊娠62例临床分析[J].广东医学,2016,37(Z1):57-59.
[14]陈正云,李小永,赵达,等.宫腔镜手术终止早期Ⅱ型剖宫产术后子宫瘢痕妊娠的临床研究[J].中华妇产科杂志,2017,52(2):669-674.
[15]陈敏.腹腔镜下切除剖宫产瘢痕妊娠病灶的临床分析[J].中国内镜杂志,2016,22(6):104-106.
[16]秦万平,鲁菊英.宫腔镜、腹腔镜联合治疗子宫瘢痕妊娠的临床分析[J].临床医药文献电子杂志,2016,3(23):4589-4589,4592.