中外医疗
中外醫療
중외의료
China Foreign Medical Treatment
2015年
24期
89-90
,共2页
剖宫产疤痕妊娠%治疗方式%临床分析
剖宮產疤痕妊娠%治療方式%臨床分析
부궁산파흔임신%치료방식%림상분석
Cesarean scar pregnancy%Treatment%Clinical Analysis
目的：分析剖宫产疤痕妊娠不同治疗方法的临床效果。方法随机选择该院2008年1月-2014年1月收治的80例剖宫产疤痕妊娠患者，根据患者停经时间及病灶大小将患者分为A组和B组，A组患者停经>3月，病灶>4 cm以上，子宫较大，分别给予开腹手术（A1组）及子宫动脉栓塞术联合开腹行剖宫产疤痕妊娠切除修补术（A2组）；B组患者停经<2月，病灶<3 cm以下，分别给予单纯药物保守治疗（B1组）及阴式剖宫产疤痕妊娠切除修补术（B2组），比较4组患者的临床症状改善情况、术中出血量、住院时间、并发症发病情况。结果 A2组患者的术中出血量（40.3±5.4）mL、住院时间（3.2±0.4）d明显低于A1组患者，A2组患者的β-HCG水平下降比为89.2%明显高于A1组患者的25.4%，差异有统计学意义（P<0.05），B2组患者的住院时间（3.1±0.8）d、恢复时间（15.8±1.4）d明显小于B1组患者，B2组患者的病灶清除率、β-HCG水平下降比为87.5%明显高于B1组患者的31.7%，且差异有统计学意义（P<0.05）。结论根据患者的不同类型，进行早期诊断并给予针对性治疗，可提高患者的临床治疗效率，对于保留患者的生育能力具有重要意义。
目的：分析剖宮產疤痕妊娠不同治療方法的臨床效果。方法隨機選擇該院2008年1月-2014年1月收治的80例剖宮產疤痕妊娠患者，根據患者停經時間及病竈大小將患者分為A組和B組，A組患者停經>3月，病竈>4 cm以上，子宮較大，分彆給予開腹手術（A1組）及子宮動脈栓塞術聯閤開腹行剖宮產疤痕妊娠切除脩補術（A2組）；B組患者停經<2月，病竈<3 cm以下，分彆給予單純藥物保守治療（B1組）及陰式剖宮產疤痕妊娠切除脩補術（B2組），比較4組患者的臨床癥狀改善情況、術中齣血量、住院時間、併髮癥髮病情況。結果 A2組患者的術中齣血量（40.3±5.4）mL、住院時間（3.2±0.4）d明顯低于A1組患者，A2組患者的β-HCG水平下降比為89.2%明顯高于A1組患者的25.4%，差異有統計學意義（P<0.05），B2組患者的住院時間（3.1±0.8）d、恢複時間（15.8±1.4）d明顯小于B1組患者，B2組患者的病竈清除率、β-HCG水平下降比為87.5%明顯高于B1組患者的31.7%，且差異有統計學意義（P<0.05）。結論根據患者的不同類型，進行早期診斷併給予針對性治療，可提高患者的臨床治療效率，對于保留患者的生育能力具有重要意義。
목적：분석부궁산파흔임신불동치료방법적림상효과。방법수궤선택해원2008년1월-2014년1월수치적80례부궁산파흔임신환자，근거환자정경시간급병조대소장환자분위A조화B조，A조환자정경>3월，병조>4 cm이상，자궁교대，분별급여개복수술（A1조）급자궁동맥전새술연합개복행부궁산파흔임신절제수보술（A2조）；B조환자정경<2월，병조<3 cm이하，분별급여단순약물보수치료（B1조）급음식부궁산파흔임신절제수보술（B2조），비교4조환자적림상증상개선정황、술중출혈량、주원시간、병발증발병정황。결과 A2조환자적술중출혈량（40.3±5.4）mL、주원시간（3.2±0.4）d명현저우A1조환자，A2조환자적β-HCG수평하강비위89.2%명현고우A1조환자적25.4%，차이유통계학의의（P<0.05），B2조환자적주원시간（3.1±0.8）d、회복시간（15.8±1.4）d명현소우B1조환자，B2조환자적병조청제솔、β-HCG수평하강비위87.5%명현고우B1조환자적31.7%，차차이유통계학의의（P<0.05）。결론근거환자적불동류형，진행조기진단병급여침대성치료，가제고환자적림상치료효솔，대우보류환자적생육능력구유중요의의。
Objective To analyze the clinical effects of different treatment modalities for cesarean scar pregnancy (CSP). Methods During January 2008 and January 2014, 80 patients with cesarean scar pregnancy underwent treatment in our hospital. According to gestational age and lesion size, we assigned them to group A and group B. The patients in the group A who had a gestational age of more than 3 months, lesion size of more than 4 cm and larger uterus were subdivided into group A1 receiving laparotomy and group A2 given uterine arterial embolization combined with open-type CSP excision repair, while those in the group B who had a gestational age of less than 2 months, lesion size of less than 3 cm were subdivided into group B1 receiving conservative medication treatment and group B2 given vaginal CSP excision repair. The improvement of symptom, intraoperative blood loss, hos-pitalization time and complications were compared between the four groups. Results The intraoperative blood loss (40.3±5.4)ml and hospitalization time (3.2±0.4)d were significantly more in the group A2 than in the group A1, while β-HCG level decreased by 89.2% in the group A2, significantly higher than that in the group A1, and the differences above were statistically significant, P<0.05; the hospitalization, (3.1 ± 0.8) d, and recovery time, (15.8 ± 1.4) d, were significantly shorter in the group B2 than in the group B1, while the lesion clearance rate was significantly higher in the group B2 than in the group B1 and theβ-HCG level de-creased by 87.5%in the group B2, significantly higher than that in the group B1, and the differences above were statistically sig-nificant, P<0.05. Conclusion Depending on the type of patients, early diagnosis and targeted therapy can improve the efficiency of the clinical treatment, which is of great significance to fertility preservation.
