摘要
目的探探究宫腹腔镜联合手术方法在治疗Ⅱ型及Ⅲ型剖宫产瘢痕部位妊娠方面的应用效果.方法回顾性分析2012年1月-2018年6月本院连续接收诊治的未破裂的外生型剖宫产瘢痕部位妊娠75例.根据患者接受治疗方案分为手术组(n=50)及介入组(n=25),观察并比较两组患者治疗有效率、住院时间、手术时间、术中出血量等,术后随访不少于24个月,随访患者术后月经量及妊娠情况.结果两组均顺利完成手术,无中转开腹,两组患者术中出血量、治疗有效率对比,差异无统计学意义(P>0.05);手术组患者住院时间和手术时间相较于对照组减少,差异有统计学意义(P<0.05),介入组患者术后月经量减少者比例明显较多,差异有统计学意义(P<0.05).结论宫腹腔镜联合手术可作为治疗未破裂型外生型剖宫产瘢痕部位妊娠的一种选择.
Objective To assess the efficacy of laparoscopy combined with hysteroscopy in the treatment of patients with typeⅡand typeⅢcesarean scar pregnancy(CSP).Methods A retrospective analysis was performed on 75 unruptured deep implantation CSP patients from January 2012 to June 2018.Patients underwent uterine artery embolization(UAE)(n=25)and laparoscopy combined with hysteroscopy(n=50)during study period.Outcomes analyzed were the success rate of the operation,length of hospital stay,operation time,intraoperative blood loss,β-hCG levels and hospitalization expense.Results All the 50 cases in the laparoscopy combined with hysteroscopy group and 25 cases in the UAE group underwent successful procedure.No conversion to open surgery was experienced in either group.The statistical differences in success rate of the operation and the levels of intraoperative blood loss were not significant between the UAE and laparoscopy combined with hysteroscopy group(P>0.05).The length of hospital stay of the laparoscopy combined with hysteroscopy group was significantly shorter than that of the UAE group(P<0.05).The operation time for the laparoscopy combined with hysteroscopy group was significantly shorter than that for the UAE group(P<0.05).The rate of spanomenorrhea in the UAE group was significantly higher than that in the laparoscopy combined with hysteroscopy group(P<0.05).Conclusion Laparoscopy combined with hysteroscopy appears to be an alternative for the management ofunruptured caesarean scar pregnancy.
作者
魏炜炜
张娜
刘轩彤
郑虹
WEI Weiwei;ZHANG Na;LIU Xuantong;ZHENG Hong(Department of Gynecology,the Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University,Changzhou,Jiangsu 213000,China;Department of Gynaecology,Baoshan People's Hospital,Baoshan,Yunnan 678000,China)
出处
《手术电子杂志》
2022年第1期39-43,共5页
Electronic Journal of Medical Operations
基金
常州市卫健委青年项目(QN201931)
关键词
剖宫产瘢痕部位妊娠
宫腹联合手术
子宫动脉栓塞
cesarean scar pregnancy
laparoscopy combined with hysteroscopy
uterine artery embolization
