Effect of transvaginal excision of pregnancy lesion in cesarean scar and hysteroplasty in the treatment of cesarean scar pregnancy
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摘要:目的 探讨经阴道子宫瘢痕部位妊娠病灶切除及子宫修补术治疗剖宫产瘢痕妊娠(CSP)的效果。方法 选取CSP患者120例随机分为2组, 对照组60例采用甲氨蝶呤注射+清宫术治疗，观察组60例采用经阴道子宫瘢痕部位妊娠病灶切除联合子宫修补术治疗，比较2组患者的治疗效果。结果 2组患者手术时间无显著差异(P>0.05); 2组间术中出血量、β-人绒毛膜促性腺激素(β-HCG)转阴时间、住院时间、术毕到首次排气时间、术后首次排气时间、术后首次下床活动时间均有显著差异(P < 0.05); 治疗后，观察组患者血β-HCG水平显著低于对照组, SF-36生活质量评价量表评分显著高于对照组(P < 0.05)。结论 对CSP患者实施经阴道子宫瘢痕部位妊娠病灶切除联合子宫修补术的治疗效果理想。
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关键词:
- 经阴道子宫瘢痕部分妊娠病灶切除术 /
- 剖宫产瘢痕妊娠 /
- 子宫修补术 /
- β-人绒毛膜促性腺激素
Abstract:Objective To investigate the effect of transvaginal excision of pregnancy lesion in cesarean scar and hysteroplasty in the treatment of cesarean scar pregnancy(CSP).Methods A total of 120 patients with CSP admitted to our hospital were enrolled in the study, and were randomly divided into two groups. The control group was treated with Methotrexate injection and uterine curettage, and the observation group was treated with transvaginal excision of pregnancy lesion in cesarean scar and hysteroplasty. Treatment effects of the two groups were compared.Results There was no significant difference in the operation time between the two groups (P>0.05). The intraoperative blood loss, negative time of β-human chorionic gonadotropin (β-HCG), hospital stay, duration from completion of surgery to first time exhaust, time to first exhaust time after surgery, and time to first ambulance showed significant differences (P < 0.05). After treatment, the blood β-HCG level in the observation group was significantly lower, and the Short-form Quality of Life Scale (SF-36) score was significantly higher than that in the control group (P < 0.05).Conclusion The treatment of uterine scar pregnancy by transvaginal excision of pregnancy lesion in cesarean scar and hysteroplasty is effective. -
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表 1 2组患者手术相关指标比较(x±s)
组别 手术时间/min 术中出血量/mL β-HCG转阴时间/d 术后首次排气时间/h 术后首次下床活动时间/h 住院时间/d 对照组 30.0±10.0 180.0±50.0 26.4±2.8 33.8±2.2 35.9±2.9 9.2±1.5 观察组 45.0±10.0 70.0±10.0* 15.2±1.9* 22.8±2.0* 24.3±2.2* 5.0±0.8* β-HCG: β-人绒毛膜促性腺激素。与对照组比较, *P < 0.05。 
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表 2 2组治疗前后血β-HCG水平变化情况比较(x±s)
mIU/mL 组别 n 治疗前 治疗后 对照组 60 4 093.8±190.3 62.9±4.9 观察组 60 4 092.9±182.9 43.8±2.0* β-HCG: β-人绒毛膜促性腺激素。与对照组比较, *P < 0.05。
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表 3 2组生活质量评分比较(x±s)
分 组别 n 治疗前 治疗后 对照组 60 57.8±1.5 78.3±5.7 观察组 60 57.4±1.3 85.4±5.3* 与对照组比较, *P < 0.05。
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