瘢痕妊娠五种手术方式治疗的效果比较
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摘要
目的探讨瘢痕妊娠五种不同手术方式的治疗效果并分析各自的优缺点。方法回顾性分析自2013年10月—2017年9月瘢痕妊娠(cesarean scar pregnancy,CPS)患者49例(其中Ⅱ型47例,Ⅲ型2例),通过比较五种不同手术方式,患者的住院时间、手术时间、术中出血量、术后血HCG下降情况比较各种手术方式优缺点。结果手术时间、住院时间以阴道子宫瘢痕妊娠病灶切除术组最短,P<0.05;术中出血量以子宫动脉栓塞术后清宫组最少,P<0.05;五种手术方式术后血HCG下降均达一半以上,P>0.05。结论五种手术方式均能达到治疗目的,但经阴道瘢痕妊娠组织切除术与其他手术方式比较其手术及住院时间明显缩短,术中出血量少,可优先选择。
Objective To explore the therapeutic effects of five surgical methods on cesarean scar pregnancy and analyze their advantages and disadvantages.Methods A retrospective study was carried out of 49 cases(including 47 cases of type II and 2 cases of type III) of cesarean scar pregnancy(CPS) in our hospital from October 2013 to September 2017.The advantages and disadvantages of five surgical methods were compared in terms of hospitalization time, operation time, intraoperative blood loss, and postoperative HCG decline.Results Operation time and hospitalization time were shortest in the group undergoing transvaginal hysterectomy of scar pregnancy tissues(P<0.05).Intraoperative blood loss was least in the group with curettage after uterine artery embolization(P<0.05).Postoperative HCG decreased by more than half after the five surgical methods(P>0.05).Conclusion All the five surgical methods are effective in the treatment of CPS.However, compared with other surgical methods, transvaginal hysterectomy of scar pregnancy tissues has the advantages of shorter hopitalization time and less intraoprative blood loss, which is a better choice for CPS.
Objective To explore the therapeutic effects of five surgical methods on cesarean scar pregnancy and analyze their advantages and disadvantages.Methods A retrospective study was carried out of 49 cases(including 47 cases of type II and 2 cases of type III) of cesarean scar pregnancy(CPS) in our hospital from October 2013 to September 2017.The advantages and disadvantages of five surgical methods were compared in terms of hospitalization time, operation time, intraoperative blood loss, and postoperative HCG decline.Results Operation time and hospitalization time were shortest in the group undergoing transvaginal hysterectomy of scar pregnancy tissues(P<0.05).Intraoperative blood loss was least in the group with curettage after uterine artery embolization(P<0.05).Postoperative HCG decreased by more than half after the five surgical methods(P>0.05).Conclusion All the five surgical methods are effective in the treatment of CPS.However, compared with other surgical methods, transvaginal hysterectomy of scar pregnancy tissues has the advantages of shorter hopitalization time and less intraoprative blood loss, which is a better choice for CPS.
引文
[1] 李锦波,陈淑琴,孔凌智,等.经阴道手术治疗剖宫产疤痕妊娠的临床分析[J].中山大学学报,2016,37(6):886-892.
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[3] Torre A,Paillusson B,Fain V,et al.Uterine artery embolization for severe sympomatic fibroids:effect on fertility and symptoms[J].Human Reproduction,2014,29(3):490-510.
[4] 李武,吕雯.宫腔镜引导取胚胎术治疗剖宫产瘢痕妊娠[J].中国内镜杂志,2016,22(3):95-97.
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[2] 阿斯燕·努斯拉提,林开清,林俊.子宫动脉栓塞术联合清宫术治疗剖宫产疤痕妊娠大量阴道出血的影响因素分析[J].中华计划生育学杂志,2016,24(12):828-831.
[3] Torre A,Paillusson B,Fain V,et al.Uterine artery embolization for severe sympomatic fibroids:effect on fertility and symptoms[J].Human Reproduction,2014,29(3):490-510.
[4] 李武,吕雯.宫腔镜引导取胚胎术治疗剖宫产瘢痕妊娠[J].中国内镜杂志,2016,22(3):95-97.
[5] Wang YL,Su TH,Chen HS.Operative laparoscopy for enraptured ectopic pregnancy in a caesarean scar[J].BJOC,2006,113(9):1035-1038.