宫腔镜终止剖宫产术后子宫瘢痕妊娠的疗效和安全性评估
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摘要
目的研究宫腔镜终止剖宫产术后子宫瘢痕妊娠的疗效和安全性。方法将我院于2015年12月~2018年5月收治的56例子宫瘢痕妊娠患者根据随机数字表法分为两组,各28例,其中对照组实施清宫术治疗,研究组采用宫腔镜治疗,对比两组患者治疗效果与激素相关数据。结果两组患者治疗前各项激素无统计学差异(P> 0.05),治疗后研究组除FSH外各项激素优于对照组,部分组间治疗前后出现差异,研究组在手术各项指标上均优于对照组,研究组治疗总有效率(89.29%)高于对照组(71.43%),差异有统计学意义(P <0.05)。结论针对剖宫产术后子宫瘢痕妊娠患者,采取宫腔镜终止妊娠术,手术时间较短,患者病灶得到有效切除,术后恢复良好,各项指标均恢复正常,值得应用。
Objective To study the curative effects and safety of hysteroscopic termination of uterine scar pregnancy after cesarean section. Methods 56 patients with uterine scar pregnancy who were admitted to our hospital from December 2015 to May 2018 were selected. According to the random number table method, they were divided into two groups, with 28 cases in each group. The control group was treated with uterine curettage while the study group was treated with hysteroscopy. The curative effects and hormone-related data were compared between the two groups. Results There was no difference in hormones between the two groups before treatment, P > 0.05. After treatment, all hormones except FSH were better in the study group than in the control group. There were differences between some groups before and after treatment and the study group was superior to the control group in various surgical indexes. The total effective rate of treatment in the study group was 89.29% higher than that in the control group(71.43%), with significant differences(P < 0.05). Conclusion For patients with uterine scar pregnancy after cesarean section, hysteroscopic termination of pregnancy has shorter surgical time and good postoperative recovery.The patients' lesions are effectively removed and all indexes return to normal. It is worth applying.
Objective To study the curative effects and safety of hysteroscopic termination of uterine scar pregnancy after cesarean section. Methods 56 patients with uterine scar pregnancy who were admitted to our hospital from December 2015 to May 2018 were selected. According to the random number table method, they were divided into two groups, with 28 cases in each group. The control group was treated with uterine curettage while the study group was treated with hysteroscopy. The curative effects and hormone-related data were compared between the two groups. Results There was no difference in hormones between the two groups before treatment, P > 0.05. After treatment, all hormones except FSH were better in the study group than in the control group. There were differences between some groups before and after treatment and the study group was superior to the control group in various surgical indexes. The total effective rate of treatment in the study group was 89.29% higher than that in the control group(71.43%), with significant differences(P < 0.05). Conclusion For patients with uterine scar pregnancy after cesarean section, hysteroscopic termination of pregnancy has shorter surgical time and good postoperative recovery.The patients' lesions are effectively removed and all indexes return to normal. It is worth applying.
引文
[1]刚君,高万里,宋风丽,等.选择性子宫动脉栓塞术联合宫腔镜手术治疗外生型剖宫产术后子宫瘢痕妊娠的疗效观察[J].医学临床研究,2017,34(7):1390-1392.
[2]段丽芬,徐虹,何萍,等.经阴道彩色多普勒超声在剖宫产术后子宫瘢痕妊娠诊治的应用[J].中国临床医学影像杂志,2014,25(4):260-262.
[3]许正芬,周丽仙,金玉明,等.高强度超声聚焦联合宫腔镜终止剖宫产术后子宫瘢痕妊娠的疗效与安全性[J].中国医学计算机成像杂志,2017,23(3):279-282.
[4]吕净上,付秀虹,王慧芬,等.宫腔镜治疗病灶最大径线≤2.5 cm的内生型剖宫产术后子宫瘢痕妊娠的疗效观察[J].中华妇产科杂志,2014,49(1):14-17.
[5]莫坚,黄建邕,黄英梅,等.选择性子宫动脉栓塞术联合宫腔镜手术治疗外生型剖宫产术后子宫瘢痕妊娠的临床分析[J].临床和实验医学杂志,2017,16(8):800-803.
[6]吴晓兰,郑高明.宫腔镜在保留剖宫产术后子宫瘢痕妊娠患者生育功能中的临床价值[J].中华妇幼临床医学杂志(电子版),2015,11(1):76-78.
[7]王瑾,谢黎明,车亚玲,等.宫腔镜终止剖宫产术后子宫瘢痕妊娠的疗效和安全性评估[J].中国性科学,2017,26(9):122-124.
[8]李晶,张春莲,方彩云,等.米非司酮、宫腔镜联合腹腔镜技术用于剖宫产术后子宫瘢痕妊娠治疗的安全性研究[J].空军医学杂志,2017,33(2):136-138.
[9]赵彦婷,刘彦肖,杨萍,等.药物联合宫腔镜对剖宫产术后子宫瘢痕妊娠患者生育功能影响[J].现代仪器与医疗,2016,22(2):85-87.
[10]陈正云,李小永,赵达,等.宫腔镜手术终止早期Ⅱ型剖宫产术后子宫瘢痕妊娠的临床研究[J].中华妇产科杂志,2017,52(10):669-674.
[11]涂艳萍,王丽敏,黄苑铭,等.超声对剖宫产术后子宫瘢痕妊娠分型的临床价值研究[J].中国超声医学杂志,2018,34(4):339-341.
[12]魏丽坤,余丽敏,穆荣梅,等.剖宫产术后子宫瘢痕妊娠再妊娠临床结局分析[J].中华医学杂志,2018,98(27):2194-2197.
[13]余喜红,高永军,高瑞,等.围术期细节护理联合认知干预对子宫瘢痕妊娠患者介入治疗负性情绪及护理质量的影响[J].护士进修杂志,2018,33(3):262-264.
[14]邓玉艳,刘庆文,陆静,等.双侧子宫动脉化疗栓塞治疗子宫瘢痕妊娠对月经的影响[J].实用医院临床杂志,2018,15(3):211-213.
[15]赵璐,杨华,马葆荣,等.瘢痕妊娠不全流产宫腔镜与清宫术治疗的比较[J].中华医学杂志,2018,98(3):217-221.
[16]刘喜伟.宫腔镜治疗剖宫产术后子宫瘢痕妊娠的疗效探讨[J].当代医学,2018,24(24):59-61.
[2]段丽芬,徐虹,何萍,等.经阴道彩色多普勒超声在剖宫产术后子宫瘢痕妊娠诊治的应用[J].中国临床医学影像杂志,2014,25(4):260-262.
[3]许正芬,周丽仙,金玉明,等.高强度超声聚焦联合宫腔镜终止剖宫产术后子宫瘢痕妊娠的疗效与安全性[J].中国医学计算机成像杂志,2017,23(3):279-282.
[4]吕净上,付秀虹,王慧芬,等.宫腔镜治疗病灶最大径线≤2.5 cm的内生型剖宫产术后子宫瘢痕妊娠的疗效观察[J].中华妇产科杂志,2014,49(1):14-17.
[5]莫坚,黄建邕,黄英梅,等.选择性子宫动脉栓塞术联合宫腔镜手术治疗外生型剖宫产术后子宫瘢痕妊娠的临床分析[J].临床和实验医学杂志,2017,16(8):800-803.
[6]吴晓兰,郑高明.宫腔镜在保留剖宫产术后子宫瘢痕妊娠患者生育功能中的临床价值[J].中华妇幼临床医学杂志(电子版),2015,11(1):76-78.
[7]王瑾,谢黎明,车亚玲,等.宫腔镜终止剖宫产术后子宫瘢痕妊娠的疗效和安全性评估[J].中国性科学,2017,26(9):122-124.
[8]李晶,张春莲,方彩云,等.米非司酮、宫腔镜联合腹腔镜技术用于剖宫产术后子宫瘢痕妊娠治疗的安全性研究[J].空军医学杂志,2017,33(2):136-138.
[9]赵彦婷,刘彦肖,杨萍,等.药物联合宫腔镜对剖宫产术后子宫瘢痕妊娠患者生育功能影响[J].现代仪器与医疗,2016,22(2):85-87.
[10]陈正云,李小永,赵达,等.宫腔镜手术终止早期Ⅱ型剖宫产术后子宫瘢痕妊娠的临床研究[J].中华妇产科杂志,2017,52(10):669-674.
[11]涂艳萍,王丽敏,黄苑铭,等.超声对剖宫产术后子宫瘢痕妊娠分型的临床价值研究[J].中国超声医学杂志,2018,34(4):339-341.
[12]魏丽坤,余丽敏,穆荣梅,等.剖宫产术后子宫瘢痕妊娠再妊娠临床结局分析[J].中华医学杂志,2018,98(27):2194-2197.
[13]余喜红,高永军,高瑞,等.围术期细节护理联合认知干预对子宫瘢痕妊娠患者介入治疗负性情绪及护理质量的影响[J].护士进修杂志,2018,33(3):262-264.
[14]邓玉艳,刘庆文,陆静,等.双侧子宫动脉化疗栓塞治疗子宫瘢痕妊娠对月经的影响[J].实用医院临床杂志,2018,15(3):211-213.
[15]赵璐,杨华,马葆荣,等.瘢痕妊娠不全流产宫腔镜与清宫术治疗的比较[J].中华医学杂志,2018,98(3):217-221.
[16]刘喜伟.宫腔镜治疗剖宫产术后子宫瘢痕妊娠的疗效探讨[J].当代医学,2018,24(24):59-61.