CAJ | 학술논문

目的：探讨宫腔镜下行清宫术对于治疗剖宫产瘢痕部位妊娠的效果。方法：收治剖宫产子宫切口瘢痕妊娠患者32例，均接受宫腔镜下清宫术，对其临床病例资料进行回顾性分析。术中宫颈注射缩宫素及垂体后叶素，术毕给予甲氨蝶呤宫颈注射，术后复查血β-HCG及盆腔彩超检查。结果：32例患者均一次性手术成功，无中转开腹、子宫穿孔发生。二者瘢痕厚度、血β-HCG值及血流阻力指数(RI)比较，差异均无统计学意义(P＞0.05)；术后3天血β-HCG下降平均(85.1％±10.3%)；术后血β-HCG在7～23天降至正常。结论：宫腔镜下清宫术对于治疗剖宫产瘢痕妊娠具有创伤小、手术时间短、出血少、术后恢复快、住院时间短的特点，是微创、直接、准确、有效的治疗方法。
목적：탐토궁강경하행청궁술대우치료부궁산반흔부위임신적효과。방법：수치부궁산자궁절구반흔임신환자32례，균접수궁강경하청궁술，대기림상병례자료진행회고성분석。술중궁경주사축궁소급수체후협소，술필급여갑안접령궁경주사，술후복사혈β-HCG급분강채초검사。결과：32례환자균일차성수술성공，무중전개복、자궁천공발생。이자반흔후도、혈β-HCG치급혈류조력지수(RI)비교，차이균무통계학의의(P＞0.05)；술후3천혈β-HCG하강평균(85.1％±10.3%)；술후혈β-HCG재7～23천강지정상。결론：궁강경하청궁술대우치료부궁산반흔임신구유창상소、수술시간단、출혈소、술후회복쾌、주원시간단적특점，시미창、직접、준학、유효적치료방법。
Objective:To explore the effect of hysteroscopic curettage for the treatment of cesarean scar pregnancy.Methods:32 patients with cesarean scar pregnancy were selected,they underwent hysteroscopic curettage.The clinical data of these patients were retrospectively analyzed.In the operation,all the patients were given the cervical injection of oxytocin and vasopressin;after operation,all the patients were given methotrexate cervical injection;after the operation,we checked the blood β-HCG and pelvic ultrasonography.Results:32 patients were all one-time successful without conversion to laparotomy and perforation of the uterus. The scar thickness,serum β-HCG and blood flow resistance index(RI) were compared,the differences were not significant(P>0.05).At 3 days after operation,serum β-HCG was decreased by an average of 85.1%±10.3%;at 7 to 23 days after operation, serum β-HCG was decreased to normal.Conclusion:There are many characteristics of application of hysteroscopic curettage for the treatment of cesarean scar pregnancy,such as little trauma,short operation time,less bleeding,faster postoperative recovery and shorter hospitalization time.It is a minimally invasive,direct,accurate and effective treatment method.