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目的:比较经阴道剖宫产瘢痕妊娠病灶清除术与腹腔镜剖宫产瘢痕妊娠病灶清除术在治疗剖宫产瘢痕妊娠中的临床疗效。方法:回顾性分析本院2009年01月至2014年10月收治的53例剖宫产瘢痕妊娠的患者,根据手术方式不同分为经阴道剖宫产瘢痕妊娠病灶清除术组及腹腔镜剖宫产瘢痕妊娠病灶清除术组,比较两种手术方式下的手术时间、术中失血量、术后住院时间、血β-HCG降至正常的时间、月经恢复正常时间及住院费用。结果:53例患者手术顺利进行,无中转开腹,未出现严重手术并发症。两种手术方式的术中出血量、术后血β-HCG降至正常时间及术后月经恢复正常时间无统计学差异(P<0.05),经阴道手术组手术时间及术后住院天数均短于腹腔镜手术组,住院费用明显少于腹腔镜手术组(P<0.05)。结论:经阴道剖宫产瘢痕妊娠病灶清除术及腹腔镜剖宫产瘢痕妊娠病灶清除术均有较好的临床疗效,经阴道剖宫产瘢痕妊娠病灶清除术适合于基层医院推广应用。
Objective: To compare the curative effect of cesarean scar pregnancy pregnancy by cesarean section cesarean scar removal and laparoscopic cesarean scar pregnancy removal. Methods: A retrospective analysis of 53 patients with cesarean scar pregnancy treated in our hospital from January 2009 to October 2014 was divided into three groups: cesarean section cesarean scar excision group and laparoscopic cesarean section Surgical treatment of scar pregnancy was performed. The operation time, intraoperative blood loss, postoperative hospital stay, blood β-HCG reduced to normal time, normal menstruation recovery time and hospitalization costs were compared between the two surgical methods. Results: The operation of 53 patients was successfully carried out without conversion to laparotomy. No serious complications were found. There was no significant difference in intraoperative blood loss, postoperative blood β-HCG normal time and postoperative menstruation recovery time (P <0.05). The operation time and postoperative hospital stay of transvaginal surgery group were both short In laparoscopic surgery group, hospitalization costs were significantly less than those in laparoscopic surgery group (P <0.05). Conclusion: Cesarean scar scar pregnancy removal and laparoscopic cesarean scar pregnancy removal of the disease have a good clinical efficacy, vaginal cesarean scar pregnancy removal of the disease suitable for the promotion and application of primary hospitals.