临床医学
臨床醫學
림상의학
CLINICAL MEDICINE
2015年
6期
24-25
,共2页
瘢痕部位妊娠%宫腹腔镜联合%子宫动脉栓塞
瘢痕部位妊娠%宮腹腔鏡聯閤%子宮動脈栓塞
반흔부위임신%궁복강경연합%자궁동맥전새
Scar pregnancy%Laparoscopy combined with hysteroscopy%Uterine artery embolization
目的：探讨宫腹腔镜联合在子宫瘢痕部位妊娠手术中的应用价值。方法回顾性分析2011年7月至2015年1月在郑州市第一人民医院妇产科就诊的80例剖宫产术后子宫瘢痕妊娠患者，其中 A 组40例行宫腹腔镜联合下病灶清除术﹢子宫修补术；B 组40例行介入治疗，术后24 h 行清宫术。结果 A 组均在宫腹腔镜联合下完成手术，无一例中转开腹、出血或子宫穿孔；B 组4例患者因双侧子宫动脉栓塞术后清宫术中子宫瘢痕部位穿孔行修补术，3例因术后复查彩超宫内残留行二次清宫术。A 组患者术中平均出血量、手术并发症、平均住院日及住院费用均低于 B 组患者，差异有统计学意义（P ﹤0.05）。结论宫腹腔镜联合在处理子宫瘢痕部位妊娠手术中具有疗效确切、手术创伤小、相比较介入治疗手术费用低、住院时间短、安全性好、并发症少、出血量较低等优点，是治疗子宫瘢痕妊娠的较理想方法。
目的：探討宮腹腔鏡聯閤在子宮瘢痕部位妊娠手術中的應用價值。方法迴顧性分析2011年7月至2015年1月在鄭州市第一人民醫院婦產科就診的80例剖宮產術後子宮瘢痕妊娠患者，其中 A 組40例行宮腹腔鏡聯閤下病竈清除術﹢子宮脩補術；B 組40例行介入治療，術後24 h 行清宮術。結果 A 組均在宮腹腔鏡聯閤下完成手術，無一例中轉開腹、齣血或子宮穿孔；B 組4例患者因雙側子宮動脈栓塞術後清宮術中子宮瘢痕部位穿孔行脩補術，3例因術後複查綵超宮內殘留行二次清宮術。A 組患者術中平均齣血量、手術併髮癥、平均住院日及住院費用均低于 B 組患者，差異有統計學意義（P ﹤0.05）。結論宮腹腔鏡聯閤在處理子宮瘢痕部位妊娠手術中具有療效確切、手術創傷小、相比較介入治療手術費用低、住院時間短、安全性好、併髮癥少、齣血量較低等優點，是治療子宮瘢痕妊娠的較理想方法。
목적：탐토궁복강경연합재자궁반흔부위임신수술중적응용개치。방법회고성분석2011년7월지2015년1월재정주시제일인민의원부산과취진적80례부궁산술후자궁반흔임신환자，기중 A 조40례행궁복강경연합하병조청제술﹢자궁수보술；B 조40례행개입치료，술후24 h 행청궁술。결과 A 조균재궁복강경연합하완성수술，무일례중전개복、출혈혹자궁천공；B 조4례환자인쌍측자궁동맥전새술후청궁술중자궁반흔부위천공행수보술，3례인술후복사채초궁내잔류행이차청궁술。A 조환자술중평균출혈량、수술병발증、평균주원일급주원비용균저우 B 조환자，차이유통계학의의（P ﹤0.05）。결론궁복강경연합재처리자궁반흔부위임신수술중구유료효학절、수술창상소、상비교개입치료수술비용저、주원시간단、안전성호、병발증소、출혈량교저등우점，시치료자궁반흔임신적교이상방법。
Objective To investigate the application value of laparoscopy combined with hysteroscopy in uterine scar pregnan-cy. Methods From July 2011 to Janurary 2015,eighty cases of cesarean scar pregnancy in the first people’s hospital of Zheng-zhou were selected. The 40 cases in group A underwent laparoscopy debridement surgery and uterus repairment,and the 40 cases in group B had interventional therapy,clean operation was done 24 h after the operation. Results Group A was completed in hyste-roscopy combined with laparoscopy operation,and no case was converted to laparotomy,bleeding or perforation of the uterus. Four patients in group B had bilateral uterine artery embolization for uterine scar after curettage of perforation neoplasty,three cases had two times of clean operation detected by intrauterine residue after operation. The average amount of bleeding,operation complica-tions,the average hospitalization days and cost of hospitalization in group A were lower than those in group B,there were significant differences(P ﹤0. 05). Conclusion Laparoscopy combined with hysteroscopy in the treatment of uterine scar pregnancy has the advantage of good curative effect,small operation wound,lower cost compared to interventional treatment,short hospitalization time,less complications,safe,low bleeding amount,is an ideal method for the treatment of uterine scar pregnancy.
