宫腔镜联合腹腔镜下辅助治疗剖宫产术后子宫瘢痕妊娠的疗效和安全性分析
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摘要
目的分析宫腔镜联合腹腔镜下辅助治疗剖宫产术后子宫瘢痕妊娠的疗效和安全性。方法选取我院2017年5月~2018年5月收治的76例剖宫产术后子宫瘢痕妊娠患者为本次研究对象,按照是否给予宫腔镜联合腹腔镜下辅助治疗将所有患者分为对照组(38例:常规清宫术)与实验组(38例:宫腔镜联合腹腔镜下辅助治疗),比较两组患者预后情况。结果实验组患者手术时间、术中出血量、月经恢复时间、住院时间等相关住院诊疗数据明显优于对照组(P <0.05)。实验组患者术后7d血β-HCG下降程度、血β-HCG下降至正常时间均明显优于对照组(P <0.05)。实验组手术成功率(94.74%)高于对照组(78.95%)(P <0.05)。实验组不良反应发生率(7.89%)明显低于对照组(21.05%)(P <0.05)。结论对于剖宫产术后子宫瘢痕妊娠患者给予宫腔镜联合腹腔镜下辅助治疗效果明显优于常规清宫术。
Objective To analyze and observe the curative effect and safety of hysteroscopy combined with laparoscopy in adjuvant treatment of cesarean scar pregnancy after cesarean section. Methods 76 patients with uterine scar pregnancy after cesarean section in our hospital from May 2017 to May 2018 were selected as research objects. According to whether adjuvant treatment of hysteroscopy combined with laparoscopy was given or not,they were divided into the control group(38 cases, routine uterine curettage) and the experimental group(38 cases,adjuvant treatment of hysteroscopy combined with laparoscopy). The prognosis of patients in two groups was compared.Results Operation time, intraoperative blood loss, menstrual recovery time, hospital stay and other relevant hospitalization data in the experimental group were significantly better than those in the control group. The difference in data was significant, P < 0.05. The decline level of blood β-HCG of 7 days after surgery and time for bloodβ-HCG decreasing to the normal in the experimental group were both significantly better than those in the control group. The difference in data was significant, P<0.05. The success rate of surgery in the experimental group(94.74%)was higher than that of the control group(78.95%). The difference in data was significant, P < 0.05. The incidence of adverse reactions in the experimental group(7.89%) was significantly lower than that in the control group(21.05%).The difference in data was significant, P < 0.05. Conclusion Hysteroscopy combined with laparoscopy in adjuvant treatment of cesarean scar pregnancy after cesarean section has better curative effects than routine uterine curettage.
Objective To analyze and observe the curative effect and safety of hysteroscopy combined with laparoscopy in adjuvant treatment of cesarean scar pregnancy after cesarean section. Methods 76 patients with uterine scar pregnancy after cesarean section in our hospital from May 2017 to May 2018 were selected as research objects. According to whether adjuvant treatment of hysteroscopy combined with laparoscopy was given or not,they were divided into the control group(38 cases, routine uterine curettage) and the experimental group(38 cases,adjuvant treatment of hysteroscopy combined with laparoscopy). The prognosis of patients in two groups was compared.Results Operation time, intraoperative blood loss, menstrual recovery time, hospital stay and other relevant hospitalization data in the experimental group were significantly better than those in the control group. The difference in data was significant, P < 0.05. The decline level of blood β-HCG of 7 days after surgery and time for bloodβ-HCG decreasing to the normal in the experimental group were both significantly better than those in the control group. The difference in data was significant, P<0.05. The success rate of surgery in the experimental group(94.74%)was higher than that of the control group(78.95%). The difference in data was significant, P < 0.05. The incidence of adverse reactions in the experimental group(7.89%) was significantly lower than that in the control group(21.05%).The difference in data was significant, P < 0.05. Conclusion Hysteroscopy combined with laparoscopy in adjuvant treatment of cesarean scar pregnancy after cesarean section has better curative effects than routine uterine curettage.
引文
[1]王静丽,杜巧梅,房雅,等.米非司酮、宫腔镜联合腹腔镜治疗剖宫产术后子宫瘢痕妊娠[J].实用中西医结合临床,2017,17(8):39-40.
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[3]李晶,张春莲,方彩云,等.米非司酮、宫腔镜联合腹腔镜技术用于剖宫产术后子宫瘢痕妊娠治疗的安全性研究[J].空军医学杂志,2017,33(2):136-138.
[4]郭亚利.腹腔镜手术与宫腔镜手术治疗剖宫产术后子宫瘢痕妊娠的临床效果比较?[J].河北医学,2015,1(2):262-265.
[5]李英,张坤,韩劲松,等.腹腔镜双侧子宫动脉阻断联合宫腔镜妊娠病灶清除治疗剖宫产瘢痕妊娠[J].中国微创外科杂志,2017,17(3):216-219.
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[7]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.
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[9]马学玲.腹腔镜双侧子宫动脉阻断联合宫腔镜妊娠病灶清除治疗剖宫产瘢痕妊娠[J].临床研究,2018,26(6):96-98.
[10]潘智茵.腹腔镜联合宫腔镜与常规清宫手术治疗剖宫产瘢痕妊娠的随机对照研究[J].现代诊断与治疗,2015,16(23):5407-5408.
[11]吴巍.剖宫产术后子宫瘢痕妊娠应用宫腔镜联合子宫动脉栓塞术治疗的疗效观察[J].当代医学,2017,23(26):96-97.
[12]王爱红,徐敏.宫腔镜下清宫术治疗剖宫产瘢痕妊娠的临床资料分析[J].中外医学研究,2018,16(27):133-134.
[13]吴文彤.腹腔镜双侧子宫动脉阻断联合宫腔镜妊娠病灶清除治疗剖宫产瘢痕妊娠的疗效探讨[J].中国现代药物应用,2018,12(6):68-69.
[14]田辉,李亚丽.分析腹腔镜双侧子宫动脉阻断联合宫腔镜妊娠病灶清除治疗剖宫产瘢痕妊娠(CSP)的疗效[J].中国医疗器械信息,2018,24(14):50-51.
[15]郭英会.腹腔镜与宫腔镜联合应用于剖宫产瘢痕妊娠的疗效观察[J].医学信息,2015,12(19):287-288.
[2]王凯.腹腔镜手术与宫腔镜手术对剖宫产术后子宫瘢痕妊娠的疗效比较[J].现代诊断与治疗,2016,27(2):367-368.
[3]李晶,张春莲,方彩云,等.米非司酮、宫腔镜联合腹腔镜技术用于剖宫产术后子宫瘢痕妊娠治疗的安全性研究[J].空军医学杂志,2017,33(2):136-138.
[4]郭亚利.腹腔镜手术与宫腔镜手术治疗剖宫产术后子宫瘢痕妊娠的临床效果比较?[J].河北医学,2015,1(2):262-265.
[5]李英,张坤,韩劲松,等.腹腔镜双侧子宫动脉阻断联合宫腔镜妊娠病灶清除治疗剖宫产瘢痕妊娠[J].中国微创外科杂志,2017,17(3):216-219.
[6]傅君,黄勇.宫腔镜与腹腔镜治疗内生型剖宫产瘢痕妊娠的比较[J].中国微创外科杂志,2015,7(10):894-896.
[7]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.
[8]刘喜伟.宫腔镜治疗剖宫产术后子宫瘢痕妊娠的疗效探讨[J].当代医学,2018,24(24):59-61.
[9]马学玲.腹腔镜双侧子宫动脉阻断联合宫腔镜妊娠病灶清除治疗剖宫产瘢痕妊娠[J].临床研究,2018,26(6):96-98.
[10]潘智茵.腹腔镜联合宫腔镜与常规清宫手术治疗剖宫产瘢痕妊娠的随机对照研究[J].现代诊断与治疗,2015,16(23):5407-5408.
[11]吴巍.剖宫产术后子宫瘢痕妊娠应用宫腔镜联合子宫动脉栓塞术治疗的疗效观察[J].当代医学,2017,23(26):96-97.
[12]王爱红,徐敏.宫腔镜下清宫术治疗剖宫产瘢痕妊娠的临床资料分析[J].中外医学研究,2018,16(27):133-134.
[13]吴文彤.腹腔镜双侧子宫动脉阻断联合宫腔镜妊娠病灶清除治疗剖宫产瘢痕妊娠的疗效探讨[J].中国现代药物应用,2018,12(6):68-69.
[14]田辉,李亚丽.分析腹腔镜双侧子宫动脉阻断联合宫腔镜妊娠病灶清除治疗剖宫产瘢痕妊娠(CSP)的疗效[J].中国医疗器械信息,2018,24(14):50-51.
[15]郭英会.腹腔镜与宫腔镜联合应用于剖宫产瘢痕妊娠的疗效观察[J].医学信息,2015,12(19):287-288.