摘要
目的在Ⅰ型子宫瘢痕处妊娠治疗中,比较单纯宫腔镜手术与行子宫动脉栓塞术后清宫的疗效。方法回顾性纳入宁波市妇女儿童医院2020年1月-2022年1月之间经B超和MRI检查诊断为Ⅰ型CSP的病例共123例,根据治疗方案不同分为两组,其中63例仅行宫腔镜手术,60例行子宫动脉栓塞术后清宫术,收集两组患者的一般临床资料、围手术期指标和术后结局指标,比较两组患者的治疗结局。结果123例手术均顺利完成,无抢救及中转腹腔镜或开腹手术,两组患者在年龄、流产次数、剖宫产次数、距末次剖宫产时间等一般情况及临床症状,体征等无明显差异(P>0.05)。两组的术中出血量、术后1天HCG下降率均无明显差异(P>0.05)。研究组的手术时间少于对照组(P<0.01)。研究组的住院时间也优于对照组(P<0.01)。并且在住院费用、HCG恢复正常时间研究组也明显少于对照组。研究组术后并发症优于对照组(P<0.05)。结论单纯宫腔镜手术可安全用于相比子宫动脉栓塞术后清宫,单纯宫腔镜手术治疗Ⅰ型CSP可以取得同样的疗效,同时具有手术时间短、费用低、并发症少等优势。
Objective To compare the efficacy of simple hysteroscopic surgery and curettage after uterine artery embolization in the treatment of type Ⅰ cesarean scar pregnancy(CSP).Methods A total of 123 cases of type Ⅰ CSP diagnosed by B-ultrasound and MRI in Ningbo Women’s&Children’s Hospital from January 2020 to January 2022 were retrospectively included.According to different treatment schemes,the patients were divided into two groups,of which 63 cases underwent hysteroscopic surgery only and 60 cases underwent uterine curettage after uterine artery embolization.The general clinical data,perioperative indicators and postoperative outcome indicators of the two groups were collected,and the treatment outcomes of the two groups of patients were compared.Results All the 123 cases were successfully completed without rescue or conversion to laparoscopy or open surgery.There were no significant differences between the two groups in terms of general conditions such as age,number of abortions,number of cesarean sections and time from the last cesarean section and clinical symptoms and signs(P>0.05).The differences in the intraoperative blood loss and the rate of hCG decline at 1 day after surgery were not significant between the two groups(P>0.05).The surgical time in the study group was shorter than that in the control group(P<0.01),and the hospital stay was also better than that in the control group(P<0.01).In addition,the hospitalization cost and time of normal HCG recovery in the study group were also significantly less or shorter than those in the control group,and postoperative complications were better compared to the control group(P<0.05).Conclusion Simple hysteroscopic surgery can more safely treat type Ⅰ CSP compared to curettage after uterine artery embolization,and the former one can achieve the same efficacy,but it has the advantages of short surgical time,low cost and few complications.
作者
何扬舟
张伟峰
HE Yangzhou;ZHANG Weifeng(School of Medicine,Ningbo University,Ningbo,Zhejiang,315000)
出处
《智慧健康》
2022年第35期108-112,共5页
Smart Healthcare
关键词
子宫瘢痕处妊娠
宫腔镜手术
子宫动脉栓塞后清宫治疗
Cesarean scar pregnancy
Hysteroscopic surgery
Curettage after uterine artery embolization
