经阴道子宫切口瘢痕妊娠手术切除的疗效观察

吴霞; 马为为; 桑学梅; 姚小艳; 刘艳

doi:10.13898/j.cnki.issn.1000-2200.2017.07.022

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经阴道子宫切口瘢痕妊娠手术切除的疗效观察

吴霞 , 马为为 , 桑学梅 , 姚小艳 , 刘艳

文章导航 > 蚌埠医学院学报 > 2017, 42 > 7: (906-909)

引用本文:

Citation:

经阴道子宫切口瘢痕妊娠手术切除的疗效观察

皖北煤电集团总医院妇产科, 安徽宿州 234000

作者简介: 吴霞(1975-),女,硕士,副主任医师.

中图分类号: R719.3

The clinical effect of transvaginal uterine incision in scarpregnancy resection

Department of Gynaecology and Obstetrics, General Hospital of Wanbei Coal and Electricity Group, Suzhou Anhui 234000, China
CLC number: R719.3

摘要: 目的：探讨经阴道行子宫瘢痕处妊娠手术切除的临床疗效。方法：剖宫产术后子宫切口瘢痕妊娠病人25例，随机分成2组，对照组17例行子宫动脉甲氨蝶呤栓塞介入+24 h内B超监护下行清宫术，观察组8例经阴道行子宫切口瘢痕妊娠病灶切除术。比较2组的临床疗效。结果：25例病人均手术成功，痊愈出院。观察组手术时间、住院费用、术后正常月经来潮时间均低于对照组（P<0.01）；术中出血量高于对照组（P<0.01）；2组住院时间、术后血β-hCG恢复正常时间差异均无统计学意义（P>0.05）。术后2周复查B超显示，观察组瘢痕包块发生率0.00%，低于对照组的52.94%（P<0.05）。2组术后月经异常率差异无统计学意义（P>0.05）。结论：经阴子宫切口瘢痕妊娠病灶切除术能一次性清除病灶，微创，易于操作，手术同时能去除瘢痕处憩室，术后并发症少，值得临床推广。
- 瘢痕妊娠 /
- 阴式子宫切口 /
- 病灶切除
Abstract: Objective:To investigate the clinical effects of transvaginal uterine scarpregnancy resection.Methods:Twenty-five patients with scarpregnancy after cesarean section were randomly divided into the control group(17 cases) and observation group(8 cases).The control group were treated with uterine artery methotrexate embolization combined with uterine curettage guilded by B-ultrasonography within 24 hours,and the observation group were treated with transvaginal uterine scarpregnancy resection.The clinical effects between two groups were compared.Results:Twenty-five patients were successfully operated and discharged.The average operation time,hospital expense and postoperative normal menstrual time in observation group were lower than those in control group(P<0.01).The intraoperative blood loss in observation group were higher than that in control group(P<0.01).The differences of the average hospital stay and postoperative blood β-hCG recovery time between two groups were not statistically significant(P>0.05).The results of B ultrasound after 2 weeks of operation showed that the incidence rate of scar mass in observation group(0.00%) was lower than that in control group(52.94%)(P<0.05).There was no statistical significance in the abnormal rate of menstruation between two groups(P>0.05).Conclusions:The transvaginal uterine scarpregnancy resection can one-time remove lesions and scar diverticulum,and is minimally invasive,easy to operate and less postoperative complications,which is worthy of clinical promotion.
- scar pregnancy /
- vaginal uterine incision /
- lesion resection

[1]	TINELLI A,TINELLI R,MALVASI A.Laparoscopic management of cervical-isthmic pregnancy:a proposal method[J].Fert Ster,2009,92(2):8293.
[2]	SCOW KM,HUANG LW,LIN YH,et al.Cesarean scar pregnancy:issues in management[J].Ultrasound Obstet Cynecol,2004,23(3):247.
[3]	吴霞,唐桂娥,桑学梅,等.米非司酮配伍米索前列醇在终止瘢痕子宫早孕中的应用[J].蚌埠医学院学报,2013,38(1):63.
[4]	MAYMON R,HALPERIN R,MENDLOVIC S,et al.Eetopic pregnancies in Caesarean section scars:the 8 yearexperience of one medical center[J].Hum Reprod,2004,19 (2):278.
[5]	GODIN PA,BASSIL S,DONNEZ J.An ectopic pregnancy developing in a previous caesarian section scar[J].Fertil Steri,1997,67(2):398.
[6]	FYLSTRA DL.Ectopic pregnancy within a cesarean scar:a review[J].Obstet Gynecol Surv,2002,57(8):537.
[7]	MAYMON R,HALERIN R,MENDLOVIC S,et al.Ectopic pregnancies in a Caesarean scar:review of the medicalapproach to aniatrogenic complication[J].Hum Reprod Update,2004,10(6):515.
[8]	张祖威,常亚杰,陈玉清.阴式子宫切口疤痕妊娠病灶清除术治疗剖宫产切口疤痕妊娠[J].中山大学学报(医学科学版),2011,32(5):689.
[9]	冯卫彤,黄卓敏,古衍,等.子宫动脉栓塞术联合B超引导下清宫术治疗剖宫产疤痕妊娠的应用研究[J].暨南大学学报(自然科学与医学版),2014,35(6):543.
[10]	龚翠梅,习风英,姚娟,等.阴式子宫疤痕妊娠病灶清除修补术治疗剖宫产疤痕妊娠的临床研究[J].中国现代医学杂志,2014,24(9):72.
[11]	陈春林,刘萍.血管性介入治疗在妇产科领域中的应用[J].中华妇产科杂志,2004,39(2):138.
[12]	夏红,李怀芳.子宫动脉栓塞与刮宫术在子宫疤痕妊娠治疗中的应用[J].同济大学学报:医学版,2013,34(6):74.
[13]	LARSEN JV,SOLOMON MH.Pregnancy in a uterine scar Sacculus-an unusual cause of postabortal haemorrhage.A case report[J].S Afr Med J,1978,53(4):142.

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经阴道子宫切口瘢痕妊娠手术切除的疗效观察

作者简介: 吴霞(1975-),女,硕士,副主任医师.

皖北煤电集团总医院妇产科, 安徽宿州 234000

收稿日期: 2016-07-15

关键词:

摘要: 目的：探讨经阴道行子宫瘢痕处妊娠手术切除的临床疗效。方法：剖宫产术后子宫切口瘢痕妊娠病人25例，随机分成2组，对照组17例行子宫动脉甲氨蝶呤栓塞介入+24 h内B超监护下行清宫术，观察组8例经阴道行子宫切口瘢痕妊娠病灶切除术。比较2组的临床疗效。结果：25例病人均手术成功，痊愈出院。观察组手术时间、住院费用、术后正常月经来潮时间均低于对照组（P<0.01）；术中出血量高于对照组（P<0.01）；2组住院时间、术后血β-hCG恢复正常时间差异均无统计学意义（P>0.05）。术后2周复查B超显示，观察组瘢痕包块发生率0.00%，低于对照组的52.94%（P<0.05）。2组术后月经异常率差异无统计学意义（P>0.05）。结论：经阴子宫切口瘢痕妊娠病灶切除术能一次性清除病灶，微创，易于操作，手术同时能去除瘢痕处憩室，术后并发症少，值得临床推广。

English Abstract

The clinical effect of transvaginal uterine incision in scarpregnancy resection

Department of Gynaecology and Obstetrics, General Hospital of Wanbei Coal and Electricity Group, Suzhou Anhui 234000, China

Received Date: 2016-07-15

Abstract: Objective:To investigate the clinical effects of transvaginal uterine scarpregnancy resection.Methods:Twenty-five patients with scarpregnancy after cesarean section were randomly divided into the control group(17 cases) and observation group(8 cases).The control group were treated with uterine artery methotrexate embolization combined with uterine curettage guilded by B-ultrasonography within 24 hours,and the observation group were treated with transvaginal uterine scarpregnancy resection.The clinical effects between two groups were compared.Results:Twenty-five patients were successfully operated and discharged.The average operation time,hospital expense and postoperative normal menstrual time in observation group were lower than those in control group(P<0.01).The intraoperative blood loss in observation group were higher than that in control group(P<0.01).The differences of the average hospital stay and postoperative blood β-hCG recovery time between two groups were not statistically significant(P>0.05).The results of B ultrasound after 2 weeks of operation showed that the incidence rate of scar mass in observation group(0.00%) was lower than that in control group(52.94%)(P<0.05).There was no statistical significance in the abnormal rate of menstruation between two groups(P>0.05).Conclusions:The transvaginal uterine scarpregnancy resection can one-time remove lesions and scar diverticulum,and is minimally invasive,easy to operate and less postoperative complications,which is worthy of clinical promotion.