宫腹腔镜联合手术治疗Ⅱ、Ⅲ型子宫瘢痕妊娠的疗效分析

Clinical efficacy analysis of hysteroscopy combined with laparoscopy in the treatment of type Ⅱ and Ⅲ uterine scar pregnancy

摘要:

目的探讨宫腹腔镜联合手术治疗Ⅱ、Ⅲ型子宫瘢痕妊娠(CSP)的治疗效果。 方法选取Ⅱ、Ⅲ型CSP患者126例随机均分为对照组和观察组。对照组子宫动脉栓塞后行清宫术,观察组采用宫腹腔镜联合手术。比较两组围手术期情况、卵巢功能、生存质量及并发症发生率。 结果观察组术中出血量、住院时间、术后阴道流血持续时间、术后月经来潮时间、血清人绒毛膜促性腺激素β恢复正常时间、住院费用、并发症发生率均低于对照组(P＜0.05)。与术前比较,术后两组促卵泡激素、黄体生成素、世界卫生组织生存质量测定量表评分升高,雌二醇降低,且观察组较对照组改善更为明显(P＜0.05)。 结论宫腹腔镜联合手术治疗Ⅱ、Ⅲ型CSP可有效改善患者临床症状,提高生存质量,减少并发症,具有临床应用价值。

Abstract:

To explore the therapeutic effect of hysteroscopy combined with laparoscopy in the treatment of type Ⅱ and Ⅲ uterine scar pregnancy (CSP). Methods126 patients with type Ⅱ and Ⅲ CSP were randomly divided into control group and observation group. The control group received uterine curettage after uterine artery embolization, and the observation group received combined hysteroscopy and laparoscopy. The perioperative condition, ovarian function, quality of life and complication rate were compared between the two groups. ResultsThe amount of intraoperative blood loss, length of hospital stay, duration of postoperative vaginal bleeding, time of menstruation, time for serum human chorionic gonadotropin β return to normal level in the observation group, hospitalization expenses and the incidence of complications in the observation group were lower than those in the control group (P＜0.05). Compared with those before operation, the scores of follicle stimulating hormone, luteinizing hormone and World Health Organization Quality of life scale were increased and estradiol decreased in the two groups after operation, and the improvement in the observation group was more obvious than that in the control group (P＜0.05). ConclusionHysteroscopy combined with laparoscopy in the treatment of type Ⅱ and Ⅲ CSP can effectively improve the clinical symptoms, improve the quality of life and reduce complications, and has clinical application value.