CAJ | 학술논문

目的：分析B超引导下低负压吸刮术治疗早期（孕8周前）孕囊型剖宫产瘢痕妊娠的临床疗效。方法选择＜孕8周，瘢痕肌层厚度≥3 mm的孕囊型剖宫产瘢痕妊娠患者44例，随机分入A、B治疗组进行治疗。 A组：MTX治疗同期行B超引导下低负压吸刮术，B组：MTX治疗后血HCG明显下降接近正常后B超引导下低负压吸刮术。观察治疗成功率、住院时间、手术出血量、并发症、子宫恢复正常及月经复潮时间等。结果 A组手术成功率95%，B组手术成功率91%。两组手术成功率、术中出血量、局部血肿形成率、术后月经复潮时间、子宫恢复正常时间比较差异无统计学意义。 A组术前HCG值明显高于B组，住院天数明显少于B组，差异有统计学意义（P＜0.05）。结论 B超引导下低负压吸刮术是孕8周前，瘢痕肌层厚度》3 mm的孕囊型剖宫产瘢痕妊娠有效、不良反应小且不影响生育功能的治疗方法，手术成功率与术前血HCG值无明显相关性。
목적：분석B초인도하저부압흡괄술치료조기（잉8주전）잉낭형부궁산반흔임신적림상료효。방법선택＜잉8주，반흔기층후도≥3 mm적잉낭형부궁산반흔임신환자44례，수궤분입A、B치료조진행치료。 A조：MTX치료동기행B초인도하저부압흡괄술，B조：MTX치료후혈HCG명현하강접근정상후B초인도하저부압흡괄술。관찰치료성공솔、주원시간、수술출혈량、병발증、자궁회복정상급월경복조시간등。결과 A조수술성공솔95%，B조수술성공솔91%。량조수술성공솔、술중출혈량、국부혈종형성솔、술후월경복조시간、자궁회복정상시간비교차이무통계학의의。 A조술전HCG치명현고우B조，주원천수명현소우B조，차이유통계학의의（P＜0.05）。결론 B초인도하저부압흡괄술시잉8주전，반흔기층후도》3 mm적잉낭형부궁산반흔임신유효、불량반응소차불영향생육공능적치료방법，수술성공솔여술전혈HCG치무명현상관성。
Objective To study the efficacy of B ultrasound guided low negative pressure suction curettage in the treatment of early (less than 8 weeks of gestation) gestational sac type of cesarean scar pregnancy. Methods 44 cases of gestational sac type of ce-sarean scar pregnancy patients with the gestation of less than 8 weeks and scar muscle thickness ≥3mm were selected and divid-ed into group A and group B for treatment. Group A: MTX treatment was given to Group A, and over the same period, B ultra-sound guided low negative pressure suction curettage was also given to them for treatment. Group B:When the level of HCG of the patients in group B declined significantly and was close to the normal level after the treatment of MTX, B ultrasound guided low negative pressure suction curettage was given to them for treatment. The clinical efficacy, hospitalization time, intraoperative blood loss, complications, the time for uterus returning to normal, menstruation recovery time of two groups of patients were observed. Results The total effective rate of group A was higher than that of group B(95%vs 91%). There was no significantly differences be-tween two groups in the clinical efficacy, intraoperative blood loss, local hematoma formation rate, postoperative menstruation re-covery time, the time for uterus returning to normal. The HCG value of group A was significantly higher than that of group B before the operation, and the hospitalization time was much less than that of the group B, the differences were statistically significant ( P<0.05). Conclusion For gestational sac type of cesarean scar pregnancy patients with the gestation of less than 8 weeks and scar muscle thickness≥3mm, B ultrasound guided low negative pressure suction curettage is effective with less complications and does not affect the reproductive function. The success rate of the operation has no significant correlation with preoperative HCG value.