作　　者： ; ;

机构地区： 茂名市人民医院

出　　处： 《当代医学》 2018年第14期38-40,共3页

摘　　要： 目的探讨腹腔镜监视下宫腔镜吸宫术治疗子宫瘢痕妊娠的效果和安全性。方法选择本院2015年1月~2017年5月期间收治的52例子宫瘢痕妊娠患者作为研究对象,根据B超提示孕囊离子宫浆膜层的距离分为两组,研究组32例,对照组20例。其中研究组采取宫、腹腔镜联合,在腹腔镜监视下宫腔镜吸宫术;对照组仅采取宫腔镜,比较两组患者治疗效果。结果 52例患者手术均顺利,研究组2例中转开腹。4例宫腔镜吸宫术后β-HCG下降不明显,再次手术治疗。研究组手术时间比对照组稍长,研究组术中出血量、术后出血时间、首次月经时间以及血β-HCG恢复正常时间均较对照组降低(t=4.190,-33.861,-4.525,-4.450,-4.901,P<0.05);研究组总有效率93.75%较对照组80.00%明显提高(Χ~2=8.291,P<0.05);研究组一次手术成功率较对照组高,但再次进行手术发生率较对照组降低,差异有统计学意义(Χ~2=8.291,P<0.05)。结论子宫瘢痕妊娠患者采用腹腔镜监视下宫腔镜吸宫术联合治疗效果更好,进一步提高治疗效果,缩短治疗时间,降低出血量,保障患者生命安全,为手术顺利完成提供保证。 Objective To analyze the clinical efficacy and safety of laparoscopic and hysteroscopic-guided uterine aspiration in the treatment of Cesarean scar pregnancy. Methods 52 patients with Cesarean scar pregnancy treated from January 2015 to May 2017 in our hospital were selected. The subjects were divided into study group （32 cases） and control group （20 cases） according to the distance between gestational sac and perimetrium under the guidance of B ultrasound. The study group received the laparoscopic and hysteroscopic-guided uterine aspiration; the control group re- ceived the hysteroscopic-guided uterine aspiration. The clinical effect was observed. Results The operation was successful. The study group had 2 cases of being transferred to laparotomy. After the aspiration, the β-HCG levels for 4 cases were not greatly decreased in resulting in the repeated operation. The operation time for study group was slightly longer than control group; the intraoperative bleeding volume, bleeding time, initial menstru- ation time and recovery time of β-HCG for study group were better than control group （t-4.190, -33.861, -4.525, -4.450, -4.901, P〈0.05）; the total effective rate for study group （93.75%） was significantly higher than control group （80.00%） （Z2 8.291, P〈0.05）; the one-time success rate for study group was significantly higher than control group; the rate of repeated operation for study group was significantly lower than control group （Z2 8.291, P〈0.05）. Conclusion The laparoscopic and hysteroscopic-guided uterine aspiration can increase the clinical efficacy, shorten the operation time, reduce the bleeding volume and improve the clinical success rate and safety.

关 键 词： 子宫瘢痕妊娠 微创手术 宫腔镜 腹腔镜

领　　域： []